Remote Benefit Verification Specialist

Job Description

Job Summary The primary function of this position is to verify insurance for payment of procedures. Essential Functions • Interact with physician offices and patients in a timely courteous manner • Verifies insurance benefits, eligibility, and pre-determination requirements for all scheduled patients • Verify correct insurance package has been loaded into the patient's chart • Review provider schedule in electronic medical record and obtain referrals for HMO patients; authorizations for procedures and radiology testing • Review provider schedules in Hospital Radiology to look for and obtain authorizations for procedures and radiology testing • Review the Authorization/Referral list in Athena and obtain/attach proper Authorizations and Referrals for pending appointments • Utilize patient financial system and other computer systems to create the authorizations/referrals and attach to all relevant appointments • Track and monitor authorizations/referrals to account for benchmark data • Coordinates with the physician's office when a required pre-determination has not been obtained • Contacts patient in advance, notifies of estimated liability and payment options • Utilize patient financial system and other computer systems to access and update surgery schedules, patient information for registration and up-front patient responsibility • Answers telephone, questions, and returns calls in a courteous timely manner • Assists and backs up other business office positions as needed • Performs other duties as assigned. • Complies with all policies and standards. Qualifications • H.S. Diploma or GED preferred • 1-2 years customer service required • 1-2 years health care / medical office experience preferred Knowledge, Skills and Abilities • To perform this job successfully, an individual should be proficient at working with computers and Google Suite. Experience working with patient financial systems, specifically patient financial systems (e.g., Athena, Availity, Tricare, ) preferred. • A good understanding of medical terminology required Apply Job!