Insurance Verification Representative

Location: Remote (with onsite training at Emerson Health, Concord, MA)
Organization: Emerson Health + Huron Managed Services

About Emerson Health

Emerson Health is a trusted community hospital system serving Concord, MA and the surrounding region. In partnership with Huron Managed Services, Emerson Health is transforming its revenue cycle operations to support exceptional patient care, strengthen operational performance, and build a more innovative, consumer-centered healthcare experience.

Joining this team means being part of a forward-thinking revenue cycle model that blends the stability of Emerson Health with the expertise and leadership of Huron.

Position Summary

The Insurance Verification Representative plays a key role in ensuring patients are financially cleared for urgent and elective services. This position secures prior authorizations, verifies insurance benefits, ensures compliance with payer requirements, and communicates with patients and providers to support a smooth, accurate pre-service process.

This role is primarily remote but requires 1-3 months of onsite training at Emerson Health's Concord, MA campus. Once fully trained, you will work independently as part of a virtual business office, collaborating regularly with clinical teams, registration, and financial counseling via phone, email, and messaging platforms.

This is an excellent opportunity for someone who enjoys detail-oriented work, problem-solving, and delivering excellent customer service in a fast-paced healthcare environment.

Key Responsibilities

* Verify patient insurance coverage and benefits; obtain prior authorizations in accordance with payer requirements
* Initiate notices of admission and complete retro-authorizations for urgent or add-on cases when applicable
* Communicate with payers, providers, and internal teams to resolve authorization denials, submit additional documentation, and process appeals
* Document all authorization activity, payer decisions, reference numbers, and financial conversations in required systems
* Notify provider offices of medical necessity issues and coordinate required ABN or Financial Liability forms before the date of service
* Submit birth notifications to MassHealth when applicable
* Update EMR systems with approvals, status updates, and payer communications
* Partner with registration and financial counseling teams to ensure accurate pre-service workflows
* Identify and report compliance risks to leadership
* Support other revenue cycle activities as assigned

Qualifications

* Minimum 2 years of experience in healthcare revenue cycle, authorization coordination, or related role requiring strong communication skills
* Broad knowledge of government payer programs and insurance requirements
* US work authorization required

Skills and Abilities

* Strong attention to detail, accuracy, and follow-through
* Excellent verbal and written communication skills
* Ability to work independently, prioritize tasks, and problem-solve efficiently
* Proficiency with Microsoft Office (Excel, Word, PowerPoint, Outlook, SharePoint, Visio)
* Ability to quickly learn client workflows, systems, and historical context
* Commitment to maintaining compliance with Huron Healthcare standards
* Flexibility to work occasional overtime or weekends if needed

Work Environment

This is a professional office or remote-office role that frequently uses computers, phones, and standard office equipment.

Physical requirements:
* Ability to remain seated at a computer for extended periods
* Repetitive keyboard and mouse use
* Regular participation in video or phone conferences
* Occasional light lifting (up to 20 lbs)