Insurance Verification Representative

Vail Health

Insurance Verification Representative verifying insurance benefits and eligibility for Vail Health patients. Collaborating with patients and staff to maintain accurate medical records and compliance with regulations.

Posted 5/20/2026full-timeRemote • Arizona, Colorado, Connecticut, Florida, Idaho, Illinois, Kansas, Maryland, Massachusetts, Minnesota, Missouri, New Jersey, North Carolina, Ohio, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Utah, Virginia, Washington, Wisconsin • 🇺🇸 United StatesJunior💰 $21 - $25 per hourWebsite

About the role

Key responsibilities & impact

Utilize online systems, phone communication, and other resources to determine eligibility and benefits prior to scheduled appointments in accordance with Vail Health timelines
Accurately identify and assign payer plan codes in the organization’s electronic health record system
Verify medical necessity in accordance with Centers for Medicare & Medicaid Services (CMS) standards and communicate coverage and eligibility details to patients
Communicate with patients, physicians, clinicians, front-end staff, and translators to gather any additional required information
Identify and obtain missing patient demographic, insurance, or pre-authorization details
Coordinate benefits by determining primary and secondary liability when applicable
Obtain pre-certifications and pre-authorizations from third-party payers per payer requirements
Escalate complex cases and notify patients or physician offices of any issues impacting verification or eligibility
Communicate patient financial responsibility directly or partner with appropriate staff to review payment and financial assistance options
Demonstrate and uphold the principles of a Just Culture
Perform other duties as assigned; must remain HIPAA compliant

Requirements

What you’ll need

One year of customer service experience preferred
Insurance verification or healthcare experience preferred
Must possess, or be able to obtain within 90 days, the computer skills necessary to complete online training, access systems, and perform job-related tasks
Experience supporting Windows systems required
Strong working knowledge of English (reading, writing, and speaking)
Degree in healthcare administration or a related field preferred

Benefits

Comp & perks

Competitive Wages & Family Benefits:
Competitive wages
Parental leave (4 weeks paid)
Housing programs
Childcare reimbursement
Comprehensive Health Benefits:
Medical
Dental
Vision
Educational Programs:
Tuition Assistance
Existing Student Loan Repayment
Specialty Certification Reimbursement
Annual Supplemental Educational Funds
Paid Time Off:
Up to five weeks in your first year of employment and continues to grow each year.
Retirement & Supplemental Insurance:
403(b) Retirement plan with immediate matching
Life insurance
Short and long-term disability
Recreation Benefits, Wellness & More:
Up to $1,000 annual wellbeing reimbursement
Recreation discounts
Pet insurance

ATS Keywords

✓ Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools

insurance verificationpayer plan codingmedical necessity verificationpre-certificationspre-authorizationscustomer servicecomputer skills

Soft Skills

communicationcoordinationproblem-solvingattention to detail