Verification of Insurance Expert

15 hours ago

Paranaque City, Calabarzon, Philippines beBeeInsurance Full time $65,000 - $98,000
Job Title: Verification of Benefits Specialist

The Verification of Benefits (VOB) specialist plays a critical role in supporting healthcare providers, treatment centers, and billing departments by verifying patients' insurance coverage and benefits. This position ensures accurate and timely verification of insurance information to facilitate smooth admissions, billing, and claims processes.

As a key member of the healthcare team, the VOB 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.

Responsibilities:
  1. Verify Patient Insurance Benefits
    1. Contact insurance companies via phone or 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 electronic health record 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 adhere to HIPAA and internal data protection policies.
    5. Ensure accurate data entry, documentation, and reporting of insurance verification and authorization status.

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