Medical Insurance Verification Specialist/Registered Nurse- Orthopedics
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What you'll do
- High-Volume Call Management: Drive daily production by handling heavy inbound and outbound patient calls, including new patient inquiries, clinical triage follow-ups, missed opportunities, and inactive patient re-engagement.
- Patient Conversion & Scheduling: Enthusiastically convert patient inquiries into booked appointments, maintaining diligent, consistent follow-up until conversion is achieved.
- Comprehensive Insurance Verification: Execute and explain the full insurance verification process—verifying active coverage, interpreting complex plan details, calculating patient financial responsibility (deductibles, copays, coinsurance, OOP maximums), and clearly communicating these costs to patients over the phone.
- Payer Navigation: Confidently handle commercial plans (HMO/PPO, Aetna, Cigna, Humana), Medicare, and Workers' Comp/PIP as required by the practice.
- Administrative & Outreach Support: Manage provider calendars, track follow-up documentation, build rapport with patients, and support ongoing business development and referral source outreach.
What they're looking for
- Valid, active Registered Nurse (RN) license.
- Proven track record of managing high-volume inbound and outbound phone calls within a fast-paced U.S. medical office setting.
- Deep operational understanding of insurance verification—knowing how and why to analyze coverage details beyond simply running eligibility checks.
- Experience in phone-based patient conversion, sales, or customer engagement within a metrics-driven environment.
- Outstanding, clear, and confident English phone presence paired with a warm, energetic, and professional customer service tone.
- Minimum 1 year of hands-on experience working with eClinicalWorks (eCW).
Summarised by NextRaise from the employer’s description, which follows in full below.
Full description from employer
About the Role We are seeking a cheery, upbeat, and production-driven Registered Nurse (RN) to serve as an Insurance Specialist / Medical Receptionist supporting our client's Orthopedics, Pain Medicine, and PM&R practice. The ideal candidate holds an active RN background, possesses an exceptional command of the English language, and brings extensive experience in high-volume call handling, phone-based appointment conversion, and a complete end-to-end understanding of the insurance verification process.
Core Responsibilities
- High-Volume Call Management: Drive daily production by handling heavy inbound and outbound patient calls, including new patient inquiries, clinical triage follow-ups, missed opportunities, and inactive patient re-engagement.
- Patient Conversion & Scheduling: Enthusiastically convert patient inquiries into booked appointments, maintaining diligent, consistent follow-up until conversion is achieved.
- Comprehensive Insurance Verification: Execute and explain the full insurance verification process—verifying active coverage, interpreting complex plan details, calculating patient financial responsibility (deductibles, copays, coinsurance, OOP maximums), and clearly communicating these costs to patients over the phone.
- Payer Navigation: Confidently handle commercial plans (HMO/PPO, Aetna, Cigna, Humana), Medicare, and Workers' Comp/PIP as required by the practice.
- Administrative & Outreach Support: Manage provider calendars, track follow-up documentation, build rapport with patients, and support ongoing business development and referral source outreach.
Requirements
Clinical Credential: Valid, active Registered Nurse (RN) license.
Healthcare Call Volume: Proven track record of managing high-volume inbound and outbound phone calls within a fast-paced U.S. medical office setting.
Insurance Expertise: Deep operational understanding of insurance verification—knowing how and why to analyze coverage details beyond simply running eligibility checks.
Sales & Engagement Mindset: Experience in phone-based patient conversion, sales, or customer engagement within a metrics-driven environment.
Communication & Demeanor: Outstanding, clear, and confident English phone presence paired with a warm, energetic, and professional customer service tone.
EHR Proficiency: Minimum 1 year of hands-on experience working with eClinicalWorks (eCW).
Please note that this is a full-time contractor position (40 hours per week) with a starting pay rate of $6 per hour depending on skillset and experience. The schedule is Monday through Friday, 8am-5pm, EST.
Company
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