Insurance Verification Specialist

Pinehurst Medical Clinic (PMC)

PMC is a recognized healthcare provider in the communities of Moore County, Lee County, Cumberland County, Chatham County, and the surrounding six counties. Locally owned and managed, PMC offers a broad range of primary and specialty care services to the communities we serve. The physicians and healthcare team of professionals at PMC share a commitment to patient-centered care that is physician-led and utilizes the latest advances in medical technology. This combination of leading-edge medicine and deep compassion for the people we serve has been a hallmark of PMC since 1952. PMC consists of over 130 providers, approximately 750 employees, and 16 locations.

Benefits to support you and your family:

PMC is proud to support the total health and well-being of our team members so they can thrive personally and professionally. That’s why, as part of the PMC team, you’ll have a package of benefits that covers your health, well-being, family, and future. For more information regarding our benefits, click here to watch our benefit video or click here for our benefits overview guide.

What will you do as a PMC Insurance Verification Specialist

As a Insurance Verification Specialist you'll review, confirm, and/or updated the payer information prior to the pre-certification process. You'll also be responsible for reviewing or performing insurance eligibility and determining the correct payer for the patient on the date of service. Along with updating insurance information, insurance verified dates, and appropriate comments in APM.

A day in the life of a PMC Insurance Verification Specialist may include:

• Review, in advance, the eligibility information from the payers in APM for all services that require pre-certifications.
• Compare the payer coverage to the DOS for all services that require pre-certifications.
• Review information at the payer website to confirm correct payer for the date of service (DOS) of the service.
• Confirm or update the correct information into APM by completing the appropriate fields (e.g., entering verification date).
• Train in the duties of other employees to assist during work periods, absenteeism, etc. as deemed necessary by Management.
• Attends various meetings and professional development programs as requested/needed.
• Performs other duties as assigned.

Required Qualifications

• High school diploma or general education degree (GED); or one to three months related experience and/or training; or equivalent combination of education and experience.

Preferred Qualifications

• Previous experience with data entry operations.
• Detailed oriented with strong financial emphasis.
• Medical office experience preferred. Insurance processing experience highly desired.

Shift: Day Shift (Monday through Friday) no weekends or holidays

Pay Type: Hourly (Non-Exempt)

The Pinehurst Medical Clinic is an equal opportunity employer and fully supports and maintains compliance with all state, federal, and local regulations and provides equal employment opportunity (EEO) to all persons regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status, or any other characteristic protected by federal, state or local law.