About this role

Handle inbound calls from Medicaid providers and members regarding insurance coverage and COB-related inquiries
Verify and validate third-party insurance coverage using MMIS systems, carrier portals, and internal tools
Accurately document and update case information across systems such as Perceptive Content and Excel
Process back-office tasks including emails, faxes, and SharePoint requests tied to TPR contracts
Interpret insurance coverage details and apply policy guidelines to ensure accurate information is communicated
Support assigned contract operations (e.g., Idaho client) through dedicated back-office workflows
Maintain compliance with HIPAA and data privacy standards while handling sensitive information

High school Diploma/GED required.
1+ year of experience in medical insurance verification, healthcare operations, or related field
1+ year of call center or phone-based customer service experience
Strong attention to detail and analytical skills for interpreting insurance coverage and data
Proficiency in Microsoft Excel and ability to navigate multiple systems simultaneously
Working knowledge of HIPAA privacy and security guidelines

Healthcare Insurance Verification Specialist

Key skills