Insurance and Benefits Coordinator

1 day ago


Cebu City, Central Visayas, Philippines beBeeEligibility Full time ₱250,000 - ₱450,000
Job Overview

This position is responsible for verifying insurance coverage, estimating patient cost-sharing responsibilities, and determining the coverage of specific services, devices, and treatment modalities under patients' insurance plans.

Key Responsibilities
  • Verify patients' insurance coverage through electronic systems or direct communication with insurance providers. Review insurance policies, benefit summaries, and pre-authorization requirements to determine coverage for medical services, devices, and treatment modalities.
  • Estimate patients' out-of-pocket expenses, including co-pays, deductibles, and co-insurance, for planned medical services or procedures. Communicate cost estimates to patients, explaining their financial responsibilities and payment options.
  • Investigate and determine if specific medical services, devices, or treatment modalities are covered under patients' insurance plans. Liaise with insurance companies to obtain pre-authorizations and prior approvals for procedures or treatments when necessary.
  • Maintain accurate records of insurance verifications, coverage determinations, and patient cost estimates. Generate reports on insurance verification outcomes, coverage trends, and reimbursement issues to support decision-making and process improvement.
Requirements
  • Strong verbal and written communication skills
  • Expert understanding of insurance benefits and coverage
  • Understanding of insurance web portals
  • Problem-solving mindset
  • Minimum 2 years of experience in benefits and verification
  • Resolution-focused mindset


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