Benefits Verification Specialist

General Job Description

Under general supervision and according to established policies and procedures, the Benefits Verification Specialist will be responsible for day-to-day administrative functions in support of efficient and effective patient care including patient registration, insurance verification, prior authorizations, scanning, faxing, calculation, and collection and reconciliation of applicable deductible, copayments/co-insurance. Individual will practice exceptional customer service and answer incoming telephone calls. Communicates and coordinates information in a knowledgeable and courteous manner with staff, patients and families. Maintains confidentiality with patients, staff and guests.

essential job Responsibilities:

• Confirms insurance eligibility and referral requirements and secures signatures on required forms, including but not limited to, Financial Policy, Consent for Treatment, HIPAA, etc..
• Ensures that all required referrals are secured and attached to the applicable appointment in the Practice Management system.
• Scans and indexes patient documents.
• Explains financial requirements to the patients or responsible parties and collects deductible, copayments/co-insurance and balances due as required.
• Conduct pre-visit chart preparation, precertification and fax duties as assigned.
• Responsible for providing complex benefits review for single visits and extended episodes of care. Reviews benefits to ensure that organization and patient understand the extent of coverage for services.
• Provides combined cost estimates for facility and professional services. Accurately utilizes cost estimate technology to create cost estimates for services and communicates estimated costs to patients and other affected parties.
• Provide financial counseling and billing information/options to patients.
• Responsible for reviewing account details for patient education and/or correction:
• Reviews balances and communicates to patient and other affected parties about outstanding balances.
• Assists patients in resolving account questions and concerns.
• Correctly identifies and advises patient on options to resolve bad debt balances.
• Advises patient about financial and special entitlement programs (such as charity programs, drug assistance programs, and other patient assistance options).
• Reviews all credit balances to accurately quote patient responsibility.
• Follows all clinic policies on safety and security; maintains restricted areas by safeguarding keyless entry codes and computer system passwords in strict confidentiality.
• Performs, organizes, and streamlines operational tasks to reduce the potential for errors.
• Maintains accuracy and productivity levels as established by department standards.
• Maintains patient safety and confidentiality at all times.
• Travels as required.
• All other duties as assigned by Practice Administrator or department supervisor.

WORK EXPERIENCE

• Minimum 1-3 years of relevant medical office experience preferred. Preference given to those with Urology experience.

Skills

• Standard operation of office equipment including computers, fax machines, copiers, printers, telephones, etc…
• Ability to work in a fast-paced environment and provide exceptional customer service and phone etiquette.
• Ability to maintain effective and organized systems to ensure timely patient flow.
• Working knowledge of medical terminology, CPT-9 and ICD-10 coding and familiarity proficiency in insurance knowledge including verifications.
• Computer proficiency and prior experience with Electronic Medical Records preferred.

PHYSICAL REQUIREMENTS

• Computer entry requiring dexterity.
• Adequate physical ability including sitting, bending and lifting up to 50 pounds and sufficient manual dexterity to perform the requisite healthcare services

Education

• High school diploma or GED; some college preferred.