How to Become an Insurance Verification Specialist

April 03, 2024 in

Insurance verification specialists are some of the essential employees in the insurance sector. One of their main job duties is to verify the patient’s benefits before their medical appointment. If you are a communicative person with compassion and empathy, you should know the career path of how to become an insurance verification specialist.

Let's see the journey you will have to go through if you decide to pursue a career as an insurance verification specialist. As a bonus, you will also reveal the best company where you can find a job.

How to Become an Insurance Verification Specialist

The path on how to become an insurance verification specialist has several steps. Firstly, you have to obtain all relevant education and training that is required for the job position.

Steps to becoming an insurance verification specialist

Obtain relevant education

Before you send out your resume, you should check if you fulfill the general educational requirements and qualifications to become an insurance verification specialist.

To become an insurance verification specialist, you will generally need a high school diploma, GED, or an equivalent education. This is also the case for the best work from home jobs for verification specialists offered by Afni.

However, when you are job seeking, you might come across a limited number of employers that will require an associate's or bachelor’s degree from their candidates.

Regarding non-formal education, having relevant coursework or certifications that are related to the job is highly recommended. Medical billing, coding, and medical administrative assistant certifications are valuable.

Lastly, an optional criterion is previous working experience in a similar role. For instance, work experience in healthcare administration or customer service is beneficial.

Insurance verification specialist training and internship

While studying, it's beneficial to gain some practical experience. You can do that by looking for internship positions. During your internship, you can see firsthand how to work as an insurance verification specialist, learn more about the legal requirements that come with the role, gain some professional behavior manners, and much more. Also, you will develop proficiency in insurance verification processes and get familiar with the commonly used software.

After you are sure you fulfill the job requirements, it is time to prepare your resume and send it out to potential employers. If you want to work with an amazing team, have a lot of benefits, get tuition reimbursement, and get paid time off all while earning competitive pay and bonuses, apply for a job at Afni.

You should also learn how to adhere to industry policies such as:

Insurance Verification Specialist Training and Internship — Source: shutterstock.com / Photo Contributor: fizkes

Obtain essential skills and attributes

Insurance verification specialists should have a wide set of skills, starting from interpersonal to technical skills. Some of the most valued by employers, and most importantly, beneficial for you to learn the job more easily, are:

Excellent communication skills and ability to adapt the conversation according to the understanding level of the other interlocutor
Computer skills, including Microsoft Excel, Office, Word, typing skills, insurance databases and software etc
Knowledge of CPT coding
Data entry
Familiarity with medical and insurance terminology
Problem-solving skills
Organization skills
Attention to detail

Once you’ve obtained proper education, training, and the necessary skills and attributes associated with insurance verification specialists, all you need to do is prepare a top-notch resume and apply for the job.

What Does an Insurance Verification Specialist Do?

To better understand what is an insurance verification specialist, it’s best to see what are their day-to-day responsibilities. Before a patient has a medical appointment, the insurance verification specialist should ensure the patient has proper insurance coverage.

In addition, an insurance verification specialist ensures accuracy. They are responsible for confirming the correctness of the patient's information, including their eligibility, benefits, and pre-authorizations required for the usage of medical services. Also, they update the patient information when necessary.

Insurance verification specialists are among the most important employees whose mission is to minimize the risk of billing errors and claim denials. Suppose a patient doesn’t have proper insurance for the services they intend to use in the medical facility. In that case, the insurance verification specialist should inform them and explain the out-of-pocket payments they should be prepared to pay.

Other job duties included in the insurance verification specialist job description can be:

Handling payments for medical care services which are not covered by the patient’s insurance
Explaining the benefits a patient has and clarifying the payment split
Obtaining referrals
Maintaining patient records and doing follow-up calls
Taking incoming calls from carrier groups, insurance providers, and recipients and answering their questions

Challenges and Rewards of the Role

As with every other insurance agent, the role of verification specialist has its challenges and rewards. If you know what they are, you can easily decide whether this is the right job position where you will feel comfortable and most fulfilled.

The first common challenge faced by an insurance verification specialist is understanding the complexities of insurance policies. Each insurance company has its own set of rules, and the policies have different coverage limitations and requirements. Navigating through them might be hard for some.

Furthermore, insurance verification specialists have to deal with a lot of people from different backgrounds on a daily basis, from patients to insurance companies and healthcare providers. If they lack proper communication skills and are not problem-solvers, they will struggle to answer all their inquiries.

Besides the challenges, being an insurance verification specialist is a rewarding job. You will ensure patients have accurate insurance coverage and help them get the necessary healthcare services. For many workers, that’s a personal satisfaction that fulfills them as individuals.

Challenges and Rewards of the Role — Source: shutterstock.com / Photo Contributor: fizkes

Become an Insurance Verification Specialist With Afni

Afni is the best place where you can land a job in the insurance sector. One of the roles in demand is an insurance verification specialist. Now that you know the insights on how to become an insurance verification specialist, you can apply to join the Afni family, earn a competitive salary, and enjoy all the other perks that the company has to offer.

About the Author

Samantha is the Recruitment Marketing Manager for Afni and brings a wealth of knowledge and tips for job seekers. She holds a bachelor's degree in public relations and marketing from Mount Saint Vincent University as well as a masters degree in digital marketing and advertising from Liberty University.