Position title
Benefits Specialist
Description
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.
Responsibilities
- 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.
Qualifications
- 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.
