Call Center Verification Specialist

Job Description

Job Description

ORGANIZATION INFORMATION:

Established in 1984, Equitas Health is a regional not-for-profit community-based healthcare system and federally qualified community health center look-alike. Its expanded mission has made it one of the nation’s largest HIV/AIDS, lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) healthcare organizations. With 22 offices in 12 cities, it serves more than 67,000 individuals in Ohio, Kentucky, and West Virginia each year through its diverse healthcare and social service delivery system focused around: primary and specialized medical care, retail pharmacy, dental, behavioral health, HIV/STI prevention, advocacy, and community health initiatives.

HOURLY RATE: $20.43-$ 24.52

BENEFITS:

• PTO
• Vision
• Dental
• Health
• 401k
• Sick time
• Paid Holidays

POSITION SUMMARY:
Reporting to the Shared Service Manager, the Verification Specialist is a member of the Call Center team and is responsible for completing pre-service patient registration, insurance verification, and other requests after scheduled appointments. This role works closely with scheduling staff through warm call transfers to ensure a seamless patient experience. Key responsibilities include maintaining accurate patient demographic and insurance information, verifying eligibility and benefits, and other various tasks to ensure efficient patient service. Through timely, patient-focused communication, this position supports service quality, operational efficiency, and revenue cycle performance.

ESSENTIAL JOB FUNCTIONS:
Essential job functions include, but are not limited to, managing inbound and outbound call center interactions to complete patient pre-registration after scheduled services and demonstrating an understanding of medical, dental, and behavioral health insurance, including coordination of benefits. This role is responsible for collecting and accurately entering patient demographic and insurance information. The specialist verifies insurance eligibility and benefits using available systems to confirm coverage after the patient visits. Also, conducts basic eligibility screenings by gathering required information and/or documentation for potential assistance referrals. In addition, this role requires providing excellent customer service, maintaining accurate documentation, and meeting established productivity and quality standards.

MAJOR AREAS OF RESPONSIBILITIES:

• Receive warm transfers from scheduling team members within the Call Center
• Manage inbound and outbound calls related to pre-registration activities
• Maintain adherence to Call Center performance standards, including call handling time, availability, and quality metrics
• Utilize call scripts and workflows to ensure consistency and compliance
• Conduct pre-registration for scheduled patients during live calls or via outbound outreach
• Accurately collect and verify patient demographic information
• Update patient records in the electronic health record (EHR) system in real time

• Obtain and document complete insurance information, including primary and secondary coverage
• Verify eligibility and benefits using payer portals, clearinghouses, or EHR tools
• Identify and document copayments, deductibles, and coverage limitations
• Escalate complex or unresolved insurance issues to appropriate resources
• Review assigned workqueue(s) daily to ensure timely completion

• Coordinate referrals regarding financial assistance programs, payment expectations, and next steps to financial counseling, when appropriate
• Deliver a high level of customer service in a fast-paced Call Center environment
• Communicate clearly, professionally, and empathetically with patients
• Ensure compliance with HIPAA and patient confidentiality standards
• Ensure all required documentation is complete, accurate, and entered in a timely manner
• Follow standardized operating procedures, workflows, and scripting
• Participate in educational training/activities and attend all staff meetings
• Perform other duties for Call Center Department including patient collection
• Other duties as assigned

EDUCATION/LICENSURE:

• High school diploma or GED is required.

Knowledge, Skills, Abilities and other Qualifications :

• 2-3 + years’ experience with healthcare insurance plans, eligibility and benefits (Commercial, Medicare, Medicaid) required.
• Experience with EPIC or other Electronic Health Record preferred.
• Understanding of HIPAA compliance
• Strong customer service skills, particularly in a Call Center or high-volume phone environment
• Ability to manage multiple systems while on live calls
• Excellent verbal communication and active listening skills
• Strong attention to detail and accuracy
• Proficiency with Microsoft Office (Access, Excel, Word and Outlook).
• Work well under pressure and possess the ability to be flexible.
• Must be able to establish and maintain professional, productive and courteous interactions with employees that promote positive teamwork, as well as with constituents of the organization. This encompasses going beyond giving and receiving instructions and includes but is not limited to (a) performing work activities requiring interacting or speaking with others, and (b) responding appropriately to constructive feedback or suggestions for improvement from a supervisor.
• Must have sensitivity to, interest in and competence in cultural differences, HIV/AIDS, minority health, sexual practices, and a demonstrated competence and interest in working with persons of the transgender community or non-gender conforming community.
• Ability to maintain confidentiality.
• Regular and predictable attendance is required.
• Must have reliable transportation and valid driver’s license.
• Ability to meet performance expectations in a metric driven environment

OTHER INFORMATION:

Background and reference checks will be conducted. In accordance with Equitas Health’s Drug-Free Workplace Policy, pre-employment drug testing will be administered. Hours may vary, including working some evenings and weekends based on workload. Individuals are not considered applicants until they have been asked to visit for an interview and at that time complete an application for employment. Completing the application does not guarantee employment. EOE/AA