Verification RepresentativeJob Description, Salary, Career Path, and Trends
A verification representative is responsible for dealing with both incoming and outgoing calls and assisting clients with their insurance verifications. Verification representatives will be in charge of solving any insurance-related issues the customer may have, and thus must be trained with the proper company policy and procedures. These representatives must also have experience dealing with difficult customers, resolving conflicts, and customer service in general. Because of this, a company must look for an ideal employee who has experience with insurance-related work, as well as experience with customer relations, and ideally, telecommunications support.
This position will usually be located in an office or call center environment. Although verification representatives are usually hired on a by-business basis, occasionally, this position may be subcontracted out by a company. An ideal employee to hire for a verification representative position usually has some insurance-related certifications and successfully stays up to date with the latest insurance policies.
Sample job description
[Your Company Name] is searching for an outgoing and assertive verification representative. Are you outgoing, conversational, and enjoy talking to people and resolving issues? If so, this position may be the position for you. The preferred verification representative will be responsible for communicating and interacting with clients through the phone, both incoming and outgoing. The ideal candidate will be able to answer insurance-related questions, assist with insurance-related troubleshooting, and authorize any claims needed. You will be responsible for managing any relevant administrative duties as well. This may include processing charges and managing billing. If this position sounds like the ideal job for you, please don’t hesitate to apply! We would love to have you on our team.
Typical duties and responsibilities
Listen and respond to patient inquiries and concerns regarding health plan benefits, account status, payment history, and medical services
Maintain contact with health plan and medical group representatives
Provide information about products and services
Take orders, calculate charges, and process billing or payments
Review or make changes to customer accounts
Record details of customer contacts and actions taken
Education and experience
This position requires a high school diploma or the equivalent.
Required skills and qualifications
Understanding of medical terminology, insurance collections, and billing
Strong written and verbal communication
Ability to think independently
Excellent interpersonal skills
Ability to recognize and manage priorities
4+ years of experience authorizing claims and dealing with insurance
Average salary and compensation
The average salary for a verification representative is $39,750 in the United States. Position salary will vary based on experience, education, company size, industry, and market.
Los Angeles, California
Minneapolis-St. Paul, Minnesota
New York City, New York
Typical work environment
A verification representative will be in charge of communicating with clients through the phone. This will include answering both incoming and outgoing phone calls. As a verification representative, you will be responsible for troubleshooting and solving any insurance problems a client or customer may be having. Your position will oftentimes be full-time between regular business hours. This job requires someone who has good communication and problem-solving skills, as well as a good head for conflict resolution. This is because the verification representative will have to listen, entertain, and respond to any customer questions, problems, or concerns relating to insurance or healthcare plans and services.
The typical work hours for a verification representative are from 9 AM to 5 PM, Monday through Friday, in an office setting.
A company that is hiring a verification representative will often look for some sort of expertise, experience, or valid certification. Some of the relevant certifications for this position include:
Client Service Specialist Certification (CCSS). The client service specialist certification aims to provide an entry-level certification for a client service specialist or company representative. Because of this, this certification will provide training and testing on proper conflict resolution procedures, customer service procedures, and other relevant topics. This certification can come into use for any representative position, including the verification representative job.
Certified Customer Experience Professional (CCEP). Becoming a certified customer experience professional can massively benefit a verification representative as it showcases a good understanding and professional level of skills in regard to customer service and customer experience. Because of this, this certification may be a relevant one to the position of verification repetitive.
Certified Medical Office Manager (CMOM). The medical office manager certification may be relevant to the position of a verification representative due to their potential of having to deal with administrative duties in the position. This certification can provide relevant information for medical office management and data entry.
The career path for a verification representative starts by obtaining a high school diploma or GED. While not always necessary to start, employers often prefer candidates that have earned certification through a professional organization like the American Medical Billing Association.
US, Bureau of Labor Statistics’ job outlook
SOC Code: 29-2098
Projected Employment in 2030
Projected 2020-2030 Percentage Shift
Projected 2020-2030 Numeric Shift
The health care industry is increasing in size year after year. More people are accessing health care services and making insurance claims for those services, which creates a growing need for verification representatives and people working in the health care billing field.
One reason for this is the aging population in the United States. Older people typically need more medical services than young people. As the oversized baby-boom generation ages, the demand for health care services generally increases across the board.
Sample interview questions
How would you handle and resolve an issue a client has with their insurance?
If a customer calls with a question related to unresolved billing or fees, how would you go about resolving this issue?
Are you confident in your ability to communicate and resolve any potential interpersonal issues that may arise?
What relevant certifications do you have that will help you with your job as a verification representative?
If we choose you, are you confident you will be able to answer any questions you are presented with, or delegate these questions to the correct specialists?
As a verification representative, what would you say your most important skill is?
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