Benefit Verification Specialist
Frisco--, TX 75034
This is a short-term contract for an annual reverification project. This position will start in early November and last for roughly 6-8 months.
- Under close supervision of the project Team Coordinators / Management team, t he 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 & 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.
- 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.
- 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.
- High school diploma or GED minimally required. Two (2) + year s 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.
- Strong customer service experience.
If interested, please apply to this job posting to be considered.