Medical Insurance Benefits Specialist
20 hours ago
We are seeking a skilled Benefits Verification Specialist to join our team.
Job Description:The Benefits Verification Specialist will play a critical role in verifying patient insurance coverage and benefits for healthcare providers, treatment centers, and billing departments.
This position ensures accurate and timely verification of insurance information to facilitate smooth admissions, billing, and claims processes.
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.
Key Responsibilities:- 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.
- 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.
- 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.
- Request and compile necessary clinical documentation for submissions.
- Communicate with clinicians to ensure all required documents are up to date and compliant.
- Ensure Compliance and Accuracy
- Maintain confidentiality and comply with HIPAA and internal data protection policies.
- Ensure accurate data entry, documentation, and reporting of insurance verification and authorization status.
- At least 2 years of proven experience in medical billing, insurance verification, or healthcare administration required.
- 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.
- Reliable internet connection and a quiet, professional remote work environment.
Our company offers a competitive compensation package and opportunities for growth and development.
Other Requirements:The ideal candidate will possess a strong understanding of medical terminology and insurance procedures, as well as excellent communication and organizational skills.
Qualifications- At least 2 years of proven experience in medical billing, insurance verification, or healthcare administration required.
- 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.
- Reliable internet connection and a quiet, professional remote work environment.
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