Financial Benefits Specialist

Description

SUMMARY

Verifies healthcare insurance eligibility, coverage and validates patients’ benefits. Recognizes patients with true balances and makes attempts to collect the debt. 

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Verifies insurance coverage utilizing Real Time Eligibility tool. Obtain and record information concerning extent of benefits. If RTE unavailable insurance coverage will be verified via website, fax or phone.
• Verifies insurance information and benefits on all new patients, and on any patient with new insurance. Follows up with patient for additional information as needed.
• Verifies referral status. Follows up with patient or PCP to verify that referral has been made if required
• Work add-ons as received via email
• Ensures all benefits are posted appropriately to the patients account as directed in the revenue cycle
• Communicates with PAR’s and front desk regarding needed information for the provider’s clinic
• Indicates the patient’s financial responsibility by entering co-pay or coinsurance in policies tab under registration

Requirements

QUALIFICATIONS

EDUCATION AND EXPERIENCE

• High School diploma or equivalent is required.
• Six months to one year of experience working with Insurance terminology is preferred.
• Two years of experience working with insurance and benefits verification preferably in a health care environment.

SKILLS/ABILITIES

• Basic computer skills
• Strong customer service
• Ability to communicate clearly and concisely in all written and oral communications, including email.
• Strong organizational skills with great attention to detail
• Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form.
• Demonstrated conflict management skills

PHYSICAL DEMANDS

While performing the duties of this job, employee is regularly required to sit, stand, walk, reach with hands and arms, and to talk and hear. Employee may be occasionally required to climb or balance, stoop, kneel, or crouch. Employee must occasionally lift, push and/or move up to 20 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.

WORK ENVIRONMENT

While performing the duties of this job, employee may be exposed to risk of infectious diseases when interacting with patients and/or family members. The employee may be occasionally exposed to wet and/or humid conditions, moving mechanical parts, fumes or airborne particles, toxic or caustic chemicals and vibration. The noise level in the work environment is usually moderate.