Insurance Verification Specialist

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Hirestaff.ai is a leading global talent acquisition and staffing solutions provider, specializing in connecting businesses with top-tier professionals across various industries. We pride ourselves on our deep industry expertise, cutting-edge technology, and personalized approach to recruitment. At Hirestaff.ai, we're committed to building long-lasting relationships with both clients and candidates, ensuring the perfect match for every role. We foster a collaborative and supportive work environment where our team members are empowered to excel and make a real impact in the world of talent acquisition.

About the Role:

This is a full-time, onsite position requiring the selected candidate to work night shifts aligned with U.S. Central Time (8 PM – 4 AM PKT) designed to support the Insurance Verification process for Psychiatry and Behavioral Health billing under U.S. healthcare systems. The Associate – Insurance Verification will be responsible for obtaining accurate patient insurance benefit information, verifying coverage, identifying authorizations/referrals, and ensuring proper documentation to streamline the revenue cycle.

The ideal candidate should have a strong command of insurance portals, an understanding of payer-specific rules, and be comfortable communicating with patients, payers, and internal teams.

Key Responsibilities:

• Verify patient insurance eligibility and benefits for psychiatric services via insurance portals and payer contact.
• Identify primary/secondary insurances, including Private Insurance, Dependent Insurance, Medicare, and Medicaid plans.
• Determine whether the case requires prior authorizations or referrals as per payer guidelines and document accordingly.
• Review Coordination of Benefits (COB) and notify patients if updates are required.
• Clearly communicate financial responsibilities to patients, including deductibles, co-pays, co-insurance, and update patient profiles accordingly.
• Demonstrate proficiency in insurance verification portals such as Availity, Navinet, UHC, etc.
• Ensure that insurance contracts and payer-specific agreements are taken into account during verification.
• Maintain up-to-date and accurate patient demographic information in the billing/EMR systems.
• Collaborate with patients and internal departments to gather all necessary information before scheduled appointments.
• Liaise with insurance carriers directly when online eligibility verification is not possible.
• Collect and forward eligibility, termination, and insurance resource information to the Billing Department for accurate claim processing.
• Answer queries from patients, front-office staff, and insurance representatives regarding eligibility, benefits, and payment obligations.
• Investigate and resolve patient or insurance-related complaints related to insurance verification or coverage issues.
• Ensure strict compliance with HIPAA and patient confidentiality regulations.

Requirements:

• Intermediate/A-levels and/or Bachelor's degree in Healthcare Administration, Finance, or a related field (preferred).
• night shifts aligned with U.S. Central Time (7 PM – 4 AM PKT)
• 1–2 years of experience in U.S. medical insurance verification, preferably in Psychiatry or Behavioral Health RCM.
• Strong working knowledge of insurance verification processes, eligibility rules, COB, and prior authorization protocols.
• Familiarity with insurance portals (e.g., Availity, Navinet, UHC Provider Portal, etc.).
• Ability to interpret payer-specific guidelines and insurance contracts.
• Proficient in using EMRs and medical billing systems.
• Excellent communication skills (verbal and written) in English.
• Proficiency in MS Excel, Google Sheets, and basic documentation/reporting tools.

• Associate

• Full-time

• Health Care Provider and Other

• Hospitals and Health Care and Insurance