Insurance Verification Team Lead

Job Summary

Leading a team of follow-up specialists, the full-time remote Insurance Verification Team Lead will guide efforts in insurance verification and prior authorizations while ensuring exceptional service and compliance in a fast-paced environment.

Key responsibilities

• Review self-pay accounts to verify insurance coverage and analyze unpaid claims
• Contact insurance carriers for claim status, submit appeals, and gather necessary documentation
• Communicate with patients to expedite claims and assist with special projects as needed

Required qualifications

• 7+ years of experience in insurance follow-up and denials management in a facility setting
• Knowledge of UB04/CMS 1450 and CMS 1500 claim forms, as well as EDI, HCPCS, ICD-9/ICD-10, and CPT
• Understanding of billing instructions and procedures for various payer sources
• High school diploma or college degree from an accredited institution
• Familiarity with Medi-Cal and effective organizational skills