Medical Insurance Specialist - Registered Nurse

About this role

We are seeking an upbeat, production-driven Virtual Nurse / Medical Insurance Specialist to support our client's Orthopedics, Pain Medicine, and PM&R practice. The ideal candidate is a registered nurse or trained nursing professional with extensive U.S. medical VA experience who combines clinical expertise with deep insurance knowledge to drive high-volume patient engagement, appointment conversions, and comprehensive insurance verifications.
Key Responsibilities

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High-Volume Call Management: Handle inbound and outbound calls, prompt callbacks for missed inquiries, and persistent follow-up to re-engage inactive or no-show patients, documenting every interaction thoroughly.

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Appointment Conversion & Patient Engagement: Leverage nursing expertise to build rapport, address patient hesitations, clarify insurance questions, and actively guide prospective patients toward confirmed appointments.

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In-Depth Insurance Verification: Conduct thorough verifications beyond basic data entry, evaluating deductible status, HMO/PPO structures, copays, coinsurance, out-of-pocket maximums, network status, and prior auth/referral needs across commercial payers, Aetna, Cigna, Humana, Medicare, and Workers' Comp/PIP.

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Scheduling & EMR Documentation: Efficiently manage physician calendars, confirm and reschedule appointments, and maintain accurate scheduling queues within eClinicalWorks (eCW).

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Referral & Outreach Support: Assist with professional outreach to physician offices, attorneys, and medical-legal contact networks to support patient volume growth as needed.

Requirements
Nursing Requirement: Must be a Registered Nurse (RN), Nurse Practitioner (NP), or hold an equivalent professional nursing degree/license (2+ years of clinical nursing experience required). NON NEGOTIABLE
Medical VA Experience: 2+ years supporting a U.S.-based practice (patient scheduling, EMR documentation, phone workflows, and remote physician collaboration).
EMR Systems: Recent and current hands-on experience using eClinicalWorks (eCW). NON NEGOTIABLE
Insurance Expertise: Deep understanding of U.S. health insurance verification, benefits breakdown, and payer guidelines.
Phone Presence & Communication: Fluent English with a clear, cheerful, and highly professional phone presence capable of building strong patient rapport.
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 skill set and experience. The schedule is Monday through Friday, 8am-5pm EST.
Originally posted on Himalayas