Medstat
Job Description
Position Overview
The Insurance Verification Executive is responsible for verifying patient insurance coverage, ensuring accurate benefit information, and supporting efficient claims processing. This role requires strong attention to detail, knowledge of healthcare documentation, and the ability to collaborate with patients, providers, and internal departments to resolve coverage issues. The ideal candidate has 1–2 years of experience in insurance verification, medical records, or healthcare administration, with working knowledge of EMR systems and HIPAA guidelines.
Key Responsibilities
Insurance Verification & Eligibility
Verify patient insurance coverage, benefits, and authorization requirements for outpatient, inpatient, and specialty services
Confirm deductible, co‑pay, co‑insurance, and out‑of‑pocket responsibilities with commercial, Medicare, and Medicaid payers.
Identify coverage discrepancies and proactively resolve issues by contacting payers, patients, or provider offices.
Review medical documentation and patient information to ensure completeness for insurance processing.
Documentation & Compliance
Accurately document verification outcomes, benefit details, and authorization requirements within EMR and patient account systems.
Maintain strict adherence to HIPAA, federal, and state regulations when handling sensitive patient information.
Support audit readiness by ensuring complete, accurate documentation aligned with organizational standards.
Patient & Provider Communication
Contact patients to clarify insurance details, obtain required information, and explain financial responsibilities.
Collaborate with providers, billing teams, and medical record departments to coordinate coverage and resolve missing information.
Provide clear, empathetic communication to support patient understanding and satisfaction.
Claims & Workflow Support
Assist with pre‑authorization submission, follow‑up, and tracking of payer approvals.
Work cross‑functionally with medical records and billing teams to ensure clean claims and reduce denials.
Monitor pending accounts and elevate issues when additional documentation or payer follow‑up is required.
Support process improvement by identifying trends in insurance rejections, eligibility issues, or payer delays.
Qualifications
1–2 years of experience in insurance verification, patient access, medical records, or healthcare administration.
Working knowledge of insurance plans, medical terminology, HIPAA requirements, and authorization workflows.
Experience with EMR systems (Epic, Cerner, NextGen, Athena, Citrix, etc.) preferred.
Strong attention to detail, organization, and accuracy.
Excellent communication skills with the ability to handle sensitive information professionally.
Proficiency in Microsoft Office (Word, Excel), data entry, and documentation tools.
Company Description Credence Global Solutions (“CGS”) is a Dallas, Texas based diversified technology‑driven financial transformation company with deep expertise in receivables management and voice‑based BPO. With focus on Receivables Management, Healthcare RCM, Technology Platforms and Contact Center verticals, CGS services leading telecommunication, healthcare, and media companies.
Healthcare providers serviced by CGS include medical transport providers, emergency physicians, health infusion service providers and diagnostic laboratories. In the telecommunication vertical, CGS serves four of the top five providers in United States.
Credence Resource Management is the flagship company of the Credence Group.
Our mantra is Excellence Beyond Belief. Challenges, growth opportunities and a passion for the Job enables us to repeatedly deliver excellence to our clients. Our teams are encouraged to continually explore their talents and pursue their interests, giving them the authority to gain knowledge and skills to truly be the expert in their domain. We strive to bring on the best and brightest, as well as to invest in their training and education, making them a seamless extension of your team.
Headquartered in Dallas TX, we have delivery offices in San Jose CA; Natchez MS; Mesa AZ & Pune India. Visit www.credencegs.com to know more about the company.
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The Insurance Verification Executive is responsible for verifying patient insurance coverage, ensuring accurate benefit information, and supporting efficient claims processing. This role requires strong attention to detail, knowledge of healthcare documentation, and the ability to collaborate with patients, providers, and internal departments to resolve coverage issues. The ideal candidate has 1–2 years of experience in insurance verification, medical records, or healthcare administration, with working knowledge of EMR systems and HIPAA guidelines.
Key Responsibilities
Insurance Verification & Eligibility
Verify patient insurance coverage, benefits, and authorization requirements for outpatient, inpatient, and specialty services
Confirm deductible, co‑pay, co‑insurance, and out‑of‑pocket responsibilities with commercial, Medicare, and Medicaid payers.
Identify coverage discrepancies and proactively resolve issues by contacting payers, patients, or provider offices.
Review medical documentation and patient information to ensure completeness for insurance processing.
Documentation & Compliance
Accurately document verification outcomes, benefit details, and authorization requirements within EMR and patient account systems.
Maintain strict adherence to HIPAA, federal, and state regulations when handling sensitive patient information.
Support audit readiness by ensuring complete, accurate documentation aligned with organizational standards.
Patient & Provider Communication
Contact patients to clarify insurance details, obtain required information, and explain financial responsibilities.
Collaborate with providers, billing teams, and medical record departments to coordinate coverage and resolve missing information.
Provide clear, empathetic communication to support patient understanding and satisfaction.
Claims & Workflow Support
Assist with pre‑authorization submission, follow‑up, and tracking of payer approvals.
Work cross‑functionally with medical records and billing teams to ensure clean claims and reduce denials.
Monitor pending accounts and elevate issues when additional documentation or payer follow‑up is required.
Support process improvement by identifying trends in insurance rejections, eligibility issues, or payer delays.
Qualifications
1–2 years of experience in insurance verification, patient access, medical records, or healthcare administration.
Working knowledge of insurance plans, medical terminology, HIPAA requirements, and authorization workflows.
Experience with EMR systems (Epic, Cerner, NextGen, Athena, Citrix, etc.) preferred.
Strong attention to detail, organization, and accuracy.
Excellent communication skills with the ability to handle sensitive information professionally.
Proficiency in Microsoft Office (Word, Excel), data entry, and documentation tools.
Company Description Credence Global Solutions (“CGS”) is a Dallas, Texas based diversified technology‑driven financial transformation company with deep expertise in receivables management and voice‑based BPO. With focus on Receivables Management, Healthcare RCM, Technology Platforms and Contact Center verticals, CGS services leading telecommunication, healthcare, and media companies.
Healthcare providers serviced by CGS include medical transport providers, emergency physicians, health infusion service providers and diagnostic laboratories. In the telecommunication vertical, CGS serves four of the top five providers in United States.
Credence Resource Management is the flagship company of the Credence Group.
Our mantra is Excellence Beyond Belief. Challenges, growth opportunities and a passion for the Job enables us to repeatedly deliver excellence to our clients. Our teams are encouraged to continually explore their talents and pursue their interests, giving them the authority to gain knowledge and skills to truly be the expert in their domain. We strive to bring on the best and brightest, as well as to invest in their training and education, making them a seamless extension of your team.
Headquartered in Dallas TX, we have delivery offices in San Jose CA; Natchez MS; Mesa AZ & Pune India. Visit www.credencegs.com to know more about the company.
#J-18808-Ljbffr