Medical Billing Specialist

18 hours ago

Province of Palawan, Mimaropa, Philippines beBeeBenefitsVerification Full time $44,152 - $62,304
Job Title: Benefits Verification Specialist

This role plays a vital part in supporting healthcare providers by verifying patients' insurance coverage and benefits.

The Benefits Verification specialist will work remotely to contact insurance companies, gather necessary coverage details, document findings, and communicate with relevant internal teams.

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.
Requirements:
  • At least 2 years of proven experience in medical billing, insurance verification, or healthcare administration is 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.
  • A reliable internet connection and a quiet, professional remote work environment are required.

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