Benefits Assurance Specialist

1 day ago

Pulong Santa Cruz, Calabarzon, Philippines beBeeVerification Full time ₱31,680 - ₱55,200
Job Title: Benefits Verification Specialist

We are seeking a skilled Benefits Verification Specialist to support healthcare providers, treatment centers, and billing departments by verifying patients' insurance coverage and benefits.

The successful candidate 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.

This position plays a critical role in ensuring accurate and timely verification of insurance information to facilitate smooth admissions, billing, and claims processes.

Key Responsibilities:

  1. Verify Patient Insurance Benefits:
    1. Contact insurance companies by phone or via portals to verify patient coverage and eligibility.
    2. Gather detailed information on covered services, copays, deductibles, and prior authorization requirements.
    3. Accurately document all benefit details in the EHR or billing system.
  2. Submit Authorization Requests:
    1. Prepare and submit prior authorization requests, including relevant clinical documentation.
    2. Follow up on pending authorizations with insurance carriers to ensure timely approvals.
    3. Maintain accurate records of all submitted authorizations.
  3. Track Authorization Expiry and Renewals:
    1. Monitor and track expiration dates for existing authorizations.
    2. Proactively initiate renewal processes prior to expiration to avoid service disruptions.
    3. Notify the clinical and administrative teams of any issues or lapses.
  4. Coordinate with Clinical Staff:
    1. Request and compile necessary clinical documentation for submissions.
    2. Communicate with clinicians to ensure all required documents are up to date and compliant
    3. Ensure Compliance and Accuracy
    4. Maintain confidentiality and comply with HIPAA and internal data protection policies
    5. Ensure accurate data entry, documentation, and reporting of insurance verification and authorization status.

Required Skills and Qualifications:

  • A minimum of 2 years of proven experience in medical billing, insurance verification, or healthcare administration is required.
  • Strong knowledge of insurance terminology and benefit structures is essential.
  • Excellent verbal and written communication skills are required.
  • Detail-oriented individuals with the ability to multitask and manage time effectively are preferred.
  • Proficiency in using spreadsheets, CRM tools, and insurance portals is required.
  • A reliable internet connection and a quiet, professional remote work environment are necessary.

Benefits:

  • This is a full-time remote opportunity.
  • The ideal candidate will have a strong understanding of medical terminology, insurance procedures, and excellent communication skills.
  • Able to work independently with minimal supervision.

Others:

  • Familiarity with electronic health records (EHRs) and billing systems is an asset.
  • Able to maintain confidentiality and comply with HIPAA and internal data protection policies.

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