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