Authorized representative vs insurance verification specialist

The differences between authorized representatives and insurance verification specialists can be seen in a few details. Each job has different responsibilities and duties. Additionally, an authorized representative has an average salary of $38,897, which is higher than the $33,043 average annual salary of an insurance verification specialist.

The top three skills for an authorized representative include patients, medical terminology and insurance verification. The most important skills for an insurance verification specialist are patients, insurance verification, and customer service.

Authorized representative vs insurance verification specialist overview

	Authorized Representative	Insurance Verification Specialist
Yearly salary	$38,897	$33,043
Hourly rate	$18.70	$15.89
Growth rate	-4%	6%
Number of jobs	64,806	71,688
Job satisfaction	-	-
Most common degree	Bachelor's Degree, 39%	Associate Degree, 27%
Average age	40	46
Years of experience	4	-

What does an authorized representative do?

An authorized representative's primary role is to represent an individual or company in different official transactions. They have the authority to communicate, liaise, negotiate, and make decisions according to goals and project requirements. Although most authorized representatives have varying responsibilities depending on their company of employment, it usually includes understanding project needs, liaising with internal and external parties, preparing and processing documents, organizing files, handling calls and correspondence, and monitoring the transactions' progress. Moreover, as an authorized representative, it is essential to be proactive at dealing with issues, resolving them promptly and professionally.

What does an insurance verification specialist do?

An insurance verification specialist is responsible for confirming a patient's insurance details and eligibility to receive medical care services. Insurance verification specialists review the insurance documents of the patients, including its coverage and limitations, and escalate concerns to the supervisor for immediate resolution. They process paperwork accordingly upon coordinating with the patients and attending health professionals. An insurance verification specialist must have excellent communication and organizational skills, finishing administrative tasks efficiently under minimal supervision.

Authorized representative vs insurance verification specialist salary

Authorized representatives and insurance verification specialists have different pay scales, as shown below.

	Authorized Representative	Insurance Verification Specialist
Average salary	$38,897	$33,043
Salary range	Between $29,000 And $50,000	Between $28,000 And $37,000
Highest paying City	Elmira, NY	Madison, WI
Highest paying state	New York	New Hampshire
Best paying company	Hill International	St. Luke's Cataract & Laser Institute
Best paying industry	Insurance	Pharmaceutical

Differences between authorized representative and insurance verification specialist education

There are a few differences between an authorized representative and an insurance verification specialist in terms of educational background:

	Authorized Representative	Insurance Verification Specialist
Most common degree	Bachelor's Degree, 39%	Associate Degree, 27%
Most common major	Business	Health Care Administration
Most common college	Stanford University	University of Pennsylvania

Authorized representative vs insurance verification specialist demographics

Here are the differences between authorized representatives' and insurance verification specialists' demographics:

	Authorized Representative	Insurance Verification Specialist
Average age	40	46
Gender ratio	Male, 29.6% Female, 70.4%	Male, 11.4% Female, 88.6%
Race ratio	Black or African American, 10.5% Unknown, 5.4% Hispanic or Latino, 23.3% Asian, 6.6% White, 53.4% American Indian and Alaska Native, 0.7%	Black or African American, 9.3% Unknown, 3.6% Hispanic or Latino, 16.0% Asian, 4.9% White, 66.1% American Indian and Alaska Native, 0.1%
LGBT Percentage	7%	7%

Differences between authorized representative and insurance verification specialist duties and responsibilities

Authorized representative example responsibilities.

Coach, evaluate and performance manage MSRs to ensure timely and accurate service to clients.
Audit requests to ensure that proper ICD-9 and CPT coding are applied.
Research coordinator and referral coordinator, obtain insurance authorization and provide information to insurance carriers or patients regarding patient accounts.
Verify (CCS), CHDP, HMO, PPO authorizations.
Adhere strictly to HIPAA privacy guidelines.
Scan Medicaid coverage in to patient's electronic file.

Insurance verification specialist example responsibilities.

Check CPT and ICD-10 codes with LCD and policies from multiple insurance companies to make sure procedures will be paid.
Support the patient privacy/confidentiality policies and regulations under HIPAA for patients and their medical records.
Confirm correct charges base on HCPCS codes.
Assist callers as well with questions about their benefits, terms and conditions of medical plans, appeals and grievances.
Provide medical record support in the absence of EMR: assist clinics and hospitals in obtaining medical records in appropriate format.
Document outbound communication from providers and veterans.

Authorized representative vs insurance verification specialist skills

Common authorized representative skills

Patients, 24%
Medical Terminology, 11%
Insurance Verification, 7%
CPT, 5%
Insurance Authorizations, 5%
Data Entry, 4%

Common insurance verification specialist skills

Patients, 25%
Insurance Verification, 15%
Customer Service, 7%
Insurance Eligibility, 5%
Data Entry, 4%
Medical Terminology, 4%

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Authorized Representative
Authorized Representative vs Insurance Verification Specialist

Updated January 8, 2025

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