Insurance Verification Representative

Overview

At SCA Health, we believe health care is about people – the patients we serve, the physicians we support and the teammates who push us forward. Behind every successful facility, procedure or innovation is a team of 15,000+ professionals working together, learning from each other and living out the mission, vision and values that define our organization. 

As part of Optum, SCA Health is redefining specialty care by developing more accessible, patient-centered practice solutions for a network of more than 370 ambulatory surgical centers, over 400 specialty physician practice clinics and numerous labs and surgical hospitals. Our work spans a broad spectrum of services, all designed to support physicians, health systems and employers in delivering efficient, value-based care to patients without compromising quality or autonomy.  

What sets SCA Health apart isn’t just what we do, it’s how we do it. Each decision we make is rooted in seven core values: 

• Clinical quality 
• Integrity 
• Service excellence 
• Teamwork 
• Accountability 
• Continuous improvement 
• Inclusion 

Our values aren’t empty words – they inform our attitudes, actions and culture. At SCA Health, your work directly impacts patients, physicians and communities. Here, you’ll find opportunities to build your career alongside a team that values your expertise, invests in your success, and shares a common mission to care for patients, serve physicians and improve health care in America.    

At SCA Health, we offer a comprehensive benefits package to support your health, well-being, and financial future. Our offerings include medical, dental, and vision coverage, 401k plan with company match, paid time off, life and disability insurance, and more. Please visit, https://careers.sca.health/why-sca, to learn more about our benefits.

Your ideas should inspire change. If you join our team, they will. 

Responsibilities

Key Responsibilities

• Verify active insurance coverage for scheduled patients.
• Review benefits, including deductibles, copayments, coinsurance, and out-of-pocket amounts.
• Determine whether prior authorizations or pre-certifications are required.
• Confirm procedure eligibility and medical necessity requirements according to payer guidelines.
• Communicate estimated patient responsibility to patients before their date of service.
• Assist with resolving insurance-related discrepancies to prevent claim denials and delays in reimbursement.
• Collaborate with scheduling, front desk, clinical staff, billing, and insurance carriers to ensure accurate patient account information.

Department Goals

• Reduce insurance-related claim denials.
• Ensure compliance with payer policies and requirements.
• Improve the patient financial experience through upfront communication and transparency.
• Support accurate and timely reimbursement for services provided.
• Minimize delays or cancellations due to unresolved insurance issues.

The Insurance Verification Department plays a critical role in both the patient experience and the revenue cycle by ensuring that coverage and financial obligations are clearly identified prior to service.

Qualifications

USD $17.98/Hr. USD $32.12/Hr.