Benefits Verification Specialist

Under close supervision of the project Team Coordinators / Management team, the Benefits Verification Specialist will contact insurance companies, on behalf of the physician’s office, to verify patient specific benefits . The Benefits Verification Specialist will ask appropriate questions regarding patient’s benefits and complete data entry and/or appropriate forms to document patient’s benefits coverage. PRIMARY DUTIES AND RESPONSIBILITIES: · Collects and reviews all patient insurance information needed to complete the benefit verification process. · Verifies patient specific benefits and precisely documents specifics for various payer plans including patient coverage, cost share, and access/provider options according to Program specific SOPs. · Verification process could include electronic validation of pharmacy coverage and medical eligibility. · Identifies any restrictions and details on how to expedite patient access. · Could include documenting and initiating prior authorization process, claims appeals, etc. · Completes quality review of work as part of finalizing product. · Reports any reimbursement trends/delays to supervisor. · Performs related duties and special projects as assigned. · Ability to work in a fast-paced office environment. · Work requires focus, flexibility, and the ability to adapt to changing work situations. · This position requires that the Associate be seated most of the day. Required: · Proficient Windows based experience including fundamentals of data entry/typing · Working knowledge of Outlook, Word, and Excel · Strong interpersonal skills and professionalism · Independent problem solver, good decision maker, and robust analytical skills · Strong attention to detail · Effective written and verbal communication Preferred: · High school diploma or GED minimally required. Two (2) + years directly related and progressively responsible experience and/or college degree. · Specific experience in medical office administration, benefit verification, coding, claims processing or customer service at an insurance company a plus · Broader experience/training may be considered in fields such as case management, social services and pharmacy technician. · Familiarity with verification of insurance benefits a plus. · Fundamental understanding of key payers including Medicaid, Medicare and private payers All your information will be kept confidential according to EEO guidelines.