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    • Working knowledge of US medical insurance terminology (e.g., CDT codes, frequencies,.
    • U.S. insurance payers via phone to obtain accurate eligibility and…
    • View all Red House Medical Billing jobs - Work from Home jobs
    • Salary Search: Insurance Verification Specialist salaries in Work from Home
    • Follow up on outstanding insurance claims with Medicare and commercial insurance payers.
    • Comfortable communicating with insurance representatives.
    • Process requests for medical records from patients, providers, insurance companies, and authorized third parties.
    • Full-Time | Permanent Work-from-Home*.
    • At least six (6) months to 1 year relevant experience in medical insurance processes.
    • As an Insurance Specialist, you will support healthcare providers by…
    • At least six (6) months to 1 year relevant experience in medical insurance processes.
    • As an Insurance Specialist, you will support healthcare providers by…
    • Everyday responsibilities include processing data from medical coders, ensuring claims get processed and paid, verifying insurance coverage, reviewing denied…
    • Reprocess authorization requests based on updated documentation, insurance feedback, or changes in patient information.
    • Prior Authorization: 1 year (Required).
    • We represent medical providers in obtaining proper reimbursement from health insurance carriers via a.
    • Reviewing electronic medical case files.
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    • Communicate with insurance companies, patients, and healthcare providers to obtain and clarify insurance information.
    • Bill primary and secondary claims.
    • Strong familiarity with insurance portals, EMR/EHR systems, and medical terminology.
    • Retrieving relevant medical history, clinical notes, and diagnostic reports…
    • Submit and manage prior authorization requests with insurance payers.
    • Experience navigating insurance payer portals and contacting payers directly.
    • Knowledge of medical credentialing and administrative terminology.
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Insurance Verification Specialist
Red House Medical Billing
Work from Home
PHP 30,000 - PHP 35,000 a month
Full-time
Apply now

Job details

PHP 30,000 - PHP 35,000 a month
Full-time
Work from Home

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

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