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

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