Insurance Verification Representative

An insurance verification representative works to ensure a patient’s healthcare benefits are covered by
required procedures. Coverage is verified with a patient’s insurance company and information regarding
their benefits are explained to the individual. With the insurance verification information, the
representative will create a patient estimate for the services the patient is scheduled for. The insurance
verification representative would obtain authorization from the insurance company. To do this, they must
obtain the patients previous medical documents and call, fax, or enter via web all information needed to
get an approval. Continues review of an authorization may be required along with setting up peer to peers
with the providers. They also help the patient understand why some procedures are covered, while other
are not.