Insurance Verification Representative – Remote (Tri‑County Area)

About the role

The University of Miami/UHealth Central Business Office is seeking a full‑time Insurance Verification Representative to work remotely supporting patient access across the Tri‑County area. You will ensure eligibility, benefits, and authorizations are verified before each patient’s service date.

Key responsibilities

• Verify patient eligibility and benefits using RTE in UChart, online insurance portals, and telephone contacts.
• Enter, edit, and validate insurance information in UChart, including guarantor, policy number, and claims address.
• Complete co‑pay checklists, create referrals, benefit‑only requests, and pre‑authorizations, documenting deductibles, co‑insurance, and out‑of‑pocket limits.
• Meet productivity standards and maintain a work queue with a 14‑day pending visit limit.
• Contact primary‑care offices and health plans to obtain authorizations for POS 22, POS 19, and POS 11 locations, attaching documentation in UChart.
• Communicate authorization status, denials, or required follow‑up to patients and internal departments.
• Provide customer service, educate patients on financial clearance, and collaborate with Department and Patient Access teams.
• Participate in process‑improvement initiatives (approximately 15% of time).

Required profile

• Experience in medical insurance verification or patient access functions.
• Familiarity with UChart and real‑time eligibility (RTE) tools.
• Strong attention to detail and ability to meet productivity and quality‑assurance targets.
• Effective communication skills for interacting with patients, providers, and health‑plan representatives.

Required skills

• UChart electronic health record system.
• RTE (real‑time eligibility) verification platforms.
• Online insurance verification portals and telephone verification processes.
• Understanding of POS coding (POS 22, POS 19, POS 11).