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Insurance Verification Specialist
Insurance Verification Specialist
Job details
Full job description
Insurance Verification Specialist (BPO) —
Remote — Philippines Full-Time, Individual Contributor
Job Summary
A leading healthcare technology company is seeking a detail-oriented Insurance Verification Specialist to join
our remote Business Process Outsourcing (BPO) team in the Philippines. You will contact
U.S. insurance payers via phone to obtain accurate eligibility and benefits
information, then enter findings into our proprietary platform. Your work ensures practices have the correct coverage details before a patient’s appointment, improving
claim acceptance rates and patient experience.
What You Will Do
- Outbound Calls: Contact insurance companies and respond to provider inquiries
to verify patient eligibility, coverage levels, frequencies, waiting periods, and
remaining benefits.
- Data Entry & Documentation: Accurately record verification results within our
proprietary platform, or CRM tools following standard operating procedures (SOPs).
- Quality & Compliance: Adhere to HIPAA, PHI, and company data-security
guidelines.
- Productivity & KPIs: Meet or exceed daily targets for Average Handle Time (AHT),
Calls per Hour (CPH), and Same-Day Turnaround (SDT).
- Issue Escalation: Flag discrepancies, missing information, or complex benefit
structures to the Team Lead for resolution.
- Continuous Improvement: Provide feedback on payer scripting, SOP updates, and
automation opportunities to streamline workflows.
- Customer Focus: Communicate professionally with U.S. payer staff,
demonstrating empathy and clear English communication.
Travel/Physical Demands
No regular travel is required. Must maintain a quiet, professional home-office
workspace with reliable internet.
Qualifications — What You Will Have
- 1–3 years of experience in BPO, KPO, or contact-center environments, preferably
supporting U.S. healthcare accounts.
- Strong English verbal and written skills; comfortable talking with U.S. payer
representatives.
- Typing speed of 30 wpm+ with high accuracy; proficient in Microsoft Office /
Google Workspace.
- Ability to work U.S. business hours (night shift PH time) and achieve performance
metrics in a fast-paced setting.
Hardware Requirements
1. Noise-Cancelling Headset
2. Dedicated UPS (Uninterruptible Power Supply) for the Internet Router – Maintains a
stable connection during brief power interruptions.
Nice to Haves
- Working knowledge of US medical insurance terminology (e.g., CDT codes, frequencies,
downgrades) and benefits structures.
Job Type: Full-time
Pay: Php30,000.00 - Php35,000.00 per month
Benefits:
- Additional leave
- Company events
- Health insurance
- Opportunities for promotion
- Promotion to permanent employee
- Work from home
Work Location: Remote