Insurance Verification Specialist

Explore your passion for helping others while being a part of an innovative community reimagining healthcare delivery. Ascend Medical is hiring an Insurance Verification Specialist to provide support to the medical assistants, care navigators, and medical billing staff.

The primary function of the Insurance Verification Specialist is to contact carrier groups to obtain eligibility information ensuring that the most updated verification is entered into the EMR and practice management software. This individual should develop and maintain effective relationships with the care navigators, medical assistants, billing specialists, and patients ensuring all patient demographic and insurance information is obtained and communicated to relevant parties.

The Specialist clarifies and verifies details of insurance coverage with private or government carriers and offers information to patients before medical services are provided. He/she tracks physician referrals and provides necessary details to billing staff. The position involves heavy phone interaction and demands top customer service and problem-solving skills in working with physicians, claims processors, medical assistants, medical billers and patients.  

Be part of a team that's revolutionizing healthcare! In this role, you’ll directly support members via phone and online appointment request form.

We fully train our new staff on our EMR and practice management software.  

Work from home/remote position-MUST BE a GEORGIA resident.

Company Summary:   

Ascend Medical, founded in 2021, is on a mission to elevate body, mind and soul. We do this by offering whole-person care, conveniently delivered. Our advanced primary care offering integrates behavioral health, metabolic health and emotional health to keep you well physically, mentally and emotionally. Our hybrid delivery model meets patients where they are, allowing patients to experience Ascend through physical, digital and at-home channels. Furthermore, Ascend accepts all major insurance plans. 

Our values: 

• Patients before Profits 
• Empathy before Expedience  
• Progress before Stagnation 
• Team before Individual 
• Safety before Everything 

With Ascend Medical, you’ll be part of a team of caring and innovative professionals who are forging a new path in healthcare – one that is patient centered, affordable and yet highly convenient. Ascend boasts the highest patient satisfaction scores in the industry (net promoter score consistently above 95) and we excel in delighting patients. 

What we offer: 

• Benefits Package- medical, dental, vision, life available on your first day! 
• 401k with matching 
• Employee Stock Option Plan 
• Generous paid time-off policy, paid parental leave, company holidays and much more!  

Key Responsibilities:  

• Insurance Verification:  
• Verify patient insurance coverage and eligibility prior to appointments.  
• Confirm coverage details, including copayments, deductibles, and coinsurance.  
• Patient Communication:  
• Communicate with patients about their insurance benefits and any potential out-of-pocket costs.  
• Notify patients of any discrepancies or issues with their insurance coverage prior to their visit.  
• Claims Processing Support:  
• Gather necessary information and documentation for insurance claims submission.  
• Assist in the resolution of denied or rejected claims with relevant insurance providers.  
• Record Keeping:  
• Maintain accurate and organized records of insurance information and verification activities.  
• Document any changes in patient insurance status and update the clinic’s EMR and practice management software.  
• Coordination with Medical Staff:  
• Work closely with physicians, APPs, MAs, care navigators, and administrative staff to ensure accurate insurance information is utilized in patient care.  
• Provide guidance regarding insurance policies that may affect patient treatment plans.  
• Problem Solving:  
• Address any insurance-related issues that arise during the patient intake process.  
• Collaborate with insurance companies to resolve authorization issues, benefit questions, or eligibility concerns.  
• Pre-authorization Requests:  
• Obtain pre-authorization for specific procedures or services as required by insurance policies.  
• Follow up on pending authorizations to ensure timely processing for patient care.  
• Reporting:  
• Prepare reports on insurance verification metrics, such as verification turnaround times and claim denial rates for management review.  
• Patient Education:  
• Educate patients about their insurance options, including clarification of covered services and out-of-pocket costs.  
• Assist in navigating alternative options for patients without insurance or those facing high costs.  

Schedule:  

• Weekdays: 8a-5p Eastern Time  
• Full-Time 

You’re a great fit for this role if you have…  

• Aspirations to Win Big. You are positive, adaptable, resilient, relentless and possess the desire to be part of an innovative community of health professionals.  
• A Strong, Consistent Work Ethic. Willing to go above and beyond. Self-directed, adaptable and resourceful. You communicate well and you have strong organization skills.
• An Ability to Leverage Resources. Strong technical and computer skills (including mastery of Microsoft Office and EMR platforms).  
• Customer Service/Sales Experience. Experience in customer/patient services. You are patient-focused and love helping others.
• Experience in Health Insurance or Healthcare Services. Prior experience in the healthcare field working with insurance is required.  
• High School graduate or equivalent 
• Bi-lingual Spanish a plus

Ascend Medical is proud to be an Equal Opportunity Employer. Our entrepreneurial culture celebrates independent thinkers and doers who can positively impact our patients and shape our industry. We believe that the unique contributions of each individual are the driver of our success. To make sure that our services and culture continue to incorporate everyone's perspectives and experience we never discriminate based on race, religion, national origin, gender identity or expression, sexual orientation, age, or marital, veteran, or disability status. We celebrate diversity and are committed to creating an inclusive environment for all, for the benefit of our employees, services, and community.