Insurance Verification Specialist

About the role

At Xploy Solutions, the Benefits Verification Specialist verifies medical, workers' compensation, or auto benefit reports for primary and secondary payers for managed care patients. The role reports to the Director of Verifications.

Responsibilities

• Learn and understand the training provided during onboarding.
• Review the benefits queue for open client requests throughout the day and manage requests using Guided Care software.
• Complete an average of 65 verifications per day at 90 days of hire and 85 or more per day after 120 days of hire.
• Maintain an error rate of less than 2 per month after 120 days of hire and an average of 65 or more verifications per day at 365 days of hire.
• Maintain a turnaround of less than 15 minutes per client-requested verification.
• Participate in monthly one-to-one meetings with leadership.
• Collaborate with colleagues and handle additional verifications from the team pool during downtime or a lull in individual caseload.
• Communicate respectfully with colleagues and leadership, and respond to client requests by email by the end of the day.
• Maintain 100% attendance, follow HR policies for time clock and PTO, and uphold company principles (GUIDE) in work-related interactions.

Requirements

• High school diploma or GED.
• Independent and self-motivated, with the ability to multitask between data entry and phone conversations.
• Innovative, detail-oriented, and strong in research and organization.
• Able to thrive in a fast-paced, high-pressure environment and collaborate with colleagues and clients.
• Strong time management and a proven ability to meet deadlines.
• Ability to communicate and exchange information and ideas so others will...

Datos clave

• High school diploma or GED required.
• Verifies medical, workers' compensation, or auto benefit reports for managed care patients.
• Reports to the Director of Verifications.
• Uses Guided Care software to manage client verification requests.