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TriasMD

Lead Insurance Verification Representative

Posted 3 days ago
$27 - $35 per hour
5-10 years experience
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AI Summary

The Lead Insurance Verification Representative performs comprehensive insurance eligibility and benefit verification for surgical procedures while calculating patient financial estimates. This role also provides daily operational support, manages complex escalations, and oversees staff onboarding and training.

Job Details: Job Location: HQ - Newport Beach, CA, Position Type: Full Time, Salary Range: $27.00 - $35.00Hourly, Job Shift: Day, TriasMD, the parent company of DISC Surgery Centers, is seeking a Lead Insurance Verification Representative to join our Revenue Cycle team. This is a Monday – Friday, remote position. This role is responsible for performing comprehensive insurance eligibility and benefit verification for scheduled surgical procedures across DISC Surgery Centers. This position will also provide daily operational support to the Insurance Verification team. Key Responsibilities: Verify insurance eligibility for upcoming procedures and communicate financial responsibility to patients Calculate and document accurate patient financial estimates Support collection of 90% of eligible collectible estimates before the scheduled procedure. Maintain accuracy and complete documentation of verification activity within HST Monitor and escalate financial-clearance concerns. Collaborate with Authorization staff, facility teams, and Revenue Cycle stakeholders to resolve discrepancies and support timely case readiness. Manage complex benefit escalations, staff onboarding and training, and coverage as needed. Maintain knowledge of payer requirements and verification processes, protect patient information and comply with HIPAA and organizational policies. Perform other duties as assigned. Qualifications: Qualifications: High school diploma or equivalent required Advanced knowledge of insurance eligibility, benefit interpretation, patient financial responsibility, and authorization requirements. Experience with HST, HST Clariti, or comparable healthcare Revenue Cycle systems preferred. Strong analytical, organizational, problem-solving, and documentation skills. Excellent communication and patient financial counseling skills. Ability to prioritize competing deadlines, resolve complex verification issues, support team workflows, and collaborate across departments. Knowledge of HIPAA, patient confidentiality, and healthcare compliance requirements. Five or more years of healthcare Revenue Cycle experience is preferred, including direct insurance verification experience. Experience in ambulatory surgery centers (ASCs), hospital outpatient departments, or surgical facilities is strongly preferred. Prior experience supporting teams or providing training is an asset. A degree in Healthcare, Business, Finance, or a related field is preferred. Compensation: $27.00 - $35.00/hour   Why Should You Work Here: Nationally Recognized Surgeons: Join a team of surgeons with national recognition in the fields of spine and sports medicine. Leader in Spine and Sports Medicine: Be part of an organization that leads the way in advancements in spine and sports medicine. Opportunity for Growth: Experience professional growth in a dynamic and growing healthcare environment.   TriasMD is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex including sexual orientation and gender identity, national origin, disability, protected Veteran Status, or any other characteristic protected by applicable federal, state or local law.

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