Insurance Verification
Specialist
Basic Objectives:
Ensure insurance eligibility and benefits are verified accurately and on time for all patients to support smooth scheduling and minimize claim denials.
Duties & Responsibilities:
- Verify insurance for next-day appointments by end of day
- Confirm coverage details (copays, deductibles, pre-auths)
- Update EMR/CRM systems with accurate insurance info
- Communicate with staff about any coverage issues
- Flag discrepancies and escalate as needed
- Complete 70+ verifications daily
Desired Outcomes:
- » 100% of next-day appointments verified
- » Minimal billing or coverage issues
- » Timely, accurate documentation
- » Improved patient experience and clinic cash flow
KPIS:
| KPI | What Does This Measure? |
|---|---|
| Next Day Verification Rate | Efficiency |
| Accuracy of Insurance Data | Quality |
| Issues Resolved Timely | Communication |
| Verifications Completed | Productivity |
| Denial Rate (Eligibility) | Quality Assurance |
