Verification of Insurance Coverage Specialist

6 hours ago

Manila, National Capital Region, Philippines beBeeBenefits Full time ₱250,000 - ₱400,000

Job Title: Benefits Specialist

Position Overview:

This role plays a critical part in supporting healthcare providers and treatment centers by verifying patients' insurance coverage and benefits. Ensuring accurate and timely verification of insurance information helps facilitate smooth admissions, billing, and claims processes.

The Benefits Verification Specialist will work remotely to contact insurance companies, gather necessary coverage details, document findings, and communicate with relevant internal teams. A strong understanding of medical terminology, insurance procedures, and excellent communication skills are essential for success in this role.

Key Responsibilities:
  1. Verify Patient Insurance Benefits
    • Contact insurance companies by phone or via portals to verify patient coverage and eligibility.
    • Gather detailed information on covered services, copays, deductibles, and prior authorization requirements.
    • Accurately document all benefit details in the EHR or billing system.
  2. Submit Authorization Requests
    • Prepare and submit prior authorization requests, including relevant clinical documentation.
    • Follow up on pending authorizations with insurance carriers to ensure timely approvals.
    • Maintain accurate records of all submitted authorizations.
  3. Track Authorization Expiry and Renewals
    • Monitor and track expiration dates for existing authorizations.
    • Proactively initiate renewal processes prior to expiration to avoid service disruptions.
    • Notify the clinical and administrative teams of any issues or lapses.
  4. Coordinate with Clinical Staff
    • Request and compile necessary clinical documentation for submissions.
    • Communicate with clinicians to ensure all required documents are up to date and compliant.
    • Maintain confidentiality and comply with HIPAA and internal data protection policies.
    • Ensure accurate data entry, documentation, and reporting of insurance verification and authorization status.
Qualifications and Skills:
  • At least 2 years of experience in medical billing, insurance verification, or healthcare administration.
  • Strong knowledge of insurance terminology and benefit structures.
  • Excellent verbal and written communication skills.
  • Detail-oriented with the ability to multitask and manage time effectively.
  • Proficient in using spreadsheets, CRM tools, and insurance portals.
Requirements:
  • Reliable internet connection.
  • A quiet, professional remote work environment.

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