Position title
Benefits Specialist

We are currently seeking a Benefits Specialist. This person will be responsible for insurance verification pre-certification, pre-authorization's, verification of eligibility status and assist with authorizations over the phone and online; collecting accurate demographics, accurate data entry, and performing any other duties necessary to provide efficient, timely services to patients.

  • Assists with the Verification of Insurance benefits, eligibility, co-pay and deductibles.
  • Pre-certification/pre-authorizations of indicated studies.
  • Ensures that all pre certifications/pre-authorizations are done in advance, before the patient is scheduled for the studies indicated.
  • Submits required notes to insurance carriers for authorization purposes.
  • Ensures documents (authorization, data, numbers are entered into EHR system appropriately)
  • Alerts the physicians for none covered services.
  • Communicates with they physicians and Nursing Supervisor with non supportive documentation.
  • Reviews account information and identify patient balances, flags account for the reception desk and collection department
  • Communicates well with all carriers: Medicare, Medicaid, Commercial, PPO,
  • Network benefits, etc.
  • Seeks advice and guidance from certified coder with regards to coding guidelines and any questions.
  • Practice and adhere to HIPPA regulations.
  • Education- High School Diploma
  • Experience with Insurance carriers: Aetna, Cigna, UHC, Blue Cross Blue Shield...etc.
  • Knowledge of basic office procedures and office equipment including, copier, fax machine, and computer
  • Skills in dealing with interpersonal issues and patient relations.
  • Ability to handle multiple priorities at once
  • Knowledge of Medical Terminology
  • Ability to maintain confidentiality of patient information.
Employment Type
Business Office
Job Location
Harlingen, Texas
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