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Feb 10, 2025

(Contract) Medical Insurance Verification Specialist

Contract Other

Job Description

Hello!

Are you passionate about helping businesses streamline their insurance verification processes? Do you find it rewarding to accurately verify coverage and resolve eligibility issues? If you enjoy tackling unique challenges and using your problem-solving and analytical skills, we have the perfect opportunity for you!

Join pMD as a flexible contract specialist, where you can enjoy:

  • Complete Flexibility: No minimum working hours or daily requirements. Work as much or as little as you want!
  • First Come, First Serve: Secure work on your schedule, based on availability.
  • Meet Your Goals: Balance your workload to meet your compensation targets.

Take control of your work-life balance and make a meaningful impact in the world of medical billing. Ready to jump in?

We are currently only accepting applications through our website. Please click the application link below if you'd like to be considered.

(Contract) Medical Insurance Verification Specialist
The (Contract) Medical Insurance Verification role at pMD is responsible for performing detailed insurance benefit verifications of all patients’ prior to claim submission to the carrier. This is an important role in identifying active coverage under the correct policy, while effectively communicating with third-party payers.

Responsibilities include:

    • verifying a patient has active coverage with the insured carrier following an inpatient encounter using an electronic eligibility solution
    • if the carrier returns ineligible, identify the correct coverage by leveraging the integrated eligibility tool, HL7 interface message, or attached facesheet. If a patient is identified as self-pay, update the financial class
    • when coverage returns that an advantage plan has been detected, identify the correct carrier and policy number to be billed using an eligibility solution. Update insurance information in the patient’s record based on the eligibility response
    • identify the correct policy to be billed when a patient is identified as being enrolled in hospice by referencing the eligibility response
    • for carriers that do not offer an electronic eligibility response, contact the carrier by phone to complete the verification. A carrier contact list will be provided to facilitate outreach

Requirements include:

    • proficient in health insurance verification and benefits
      knowledge of CPT codes and basic medical terminology (preferred)
    • must be able to work independently in a fast-paced environment
    • exceptional attention to detail
    • make phone calls to insurance carriers between the operating hours of 8 am and 6 pm EST
    • work as a sole proprietor or have or be willing to register a business per independent contractor guidelines
    • reside in the U.S.
Rate: $0.92 per claim. This role is paid on a per-verified claim basis.
Candidates must be authorized to work in the U.S. as a precondition of employment.

Required Experience Level

Intermediate Level

Minimum Education

No formal education required

Minimum Experience Required

0-2 years

Required Travel

No required travel

Applicant Location

US residents only
pMD
About pMD

Hello!

Are you passionate about helping businesses clean up their old claims? Do you find it rewarding to efficiently resolve billing issues? If you love tackling unique challenges and using your problem-solving and analytical skills, we have the perfect opportunity for you!

Join pMD as a flexible contract specialist, where you can enjoy:

  • Complete Flexibility: No minimum working hours or daily requirements. Work as much or as little as you want!
  • First Come, First Serve: Secure work on your schedule, based on availability.
  • Meet Your Goals: Balance your workload to meet your compensation targets.

Take control of your work-life balance and make a meaningful impact in the world of medical billing. Ready to jump in? Job details are below. We are only accepting applications through our online job portal. If you'd like to be considered for this position, please apply using the job link here.

(Contract) Medical A/R Follow Up Specialist
The (Contract) Medical A/R Follow Up Specialist role at pMD helps our physician practices maximize revenue through aggressive follow up on healthcare insurance receivables. This role will help our team gain valuable information to aid in the resolution of outstanding claims and support prompt payment.

Responsibilities include:

    • contact insurance carriers to inquire about the status of past due accounts to secure payment of claims
    • conduct research to update status of unpaid or denied claims
    • document details of activity on each account in software solution program
    • demonstrate the highest level of compliance with all laws and regulations, including but not limited to HIPAA

Requirements include:

    • make phone calls to insurance carriers between the operating hours of 8 am and 6 pm EST
    • exceptional attention to detail
    • experience communicating effectively with payers
    • prior collections or medical billing experience with a basic understanding of ICD-10, HCPCS, and medical terminology
    • W9 required - work as a sole proprietor or have or be willing to register a business per independent contractor guidelines
    • reside in the U.S.
Rate: $5.00 per claim. This role is paid on a per-verified claim basis.
Candidates must be authorized to work in the U.S. as a precondition of employment.
Apply Now