Benefit Verification Specialist

Frisco--, TX 75034

Posted: 09/14/2017 Category: Professional Job Number: 23063


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.

Position Summary:
  • 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.

Required Qualifications:
  • 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.

Preferred Qualifications:
  • 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.


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