We are looking for a detail-oriented Medical Insurance Claims Specialist to support a fast-moving admissions environment in Wernersville, Pennsylvania. This Long-term Contract position focuses on confirming insurance coverage, reviewing benefit details, and communicating findings that help determine treatment access. The ideal candidate is comfortable managing a high volume of requests, navigating payer portals, and following up directly with insurance carriers when additional clarification is needed.

Responsibilities:

• Review incoming admission-related requests and confirm insurance coverage, benefit levels, and eligibility details for prospective patients.
• Access multiple payer systems and online resources to gather accurate policy information and document findings clearly for the admissions team.
• Communicate deductible, coverage, and benefit information promptly so teams can make informed decisions about treatment coordination.
• Contact insurance providers by phone when portal information is incomplete, inconsistent, or requires confirmation.
• Partner closely with admissions and call center staff to support timely responses in a high-volume, fast-paced setting.
• Perform ongoing reverification of existing cases throughout the week to ensure coverage information remains current and accurate.
• Manage a steady workload of insurance reviews each day while maintaining attention to detail and turnaround expectations.
• Record verification outcomes thoroughly and escalate discrepancies or unresolved issues to the appropriate internal contacts as needed.