Benefit Verification Coordinator

5 days ago


The Woodlands, United States CornerStone Staffing Full time

CornerStone Staffing is seeking a Benefit Verification Coordinator with a great team work ethic and with experience in fast paced environment. If you have this experience we have the right job for you


Job ID: 148330

Location: 100% Remote

Pay: $24.50

Schedule: M-F 8a -6p


Job Description:

Verifies insurance benefits for new patient referrals and re-verifies existing patient benefits as indicated by policy. Obtains pre-certifications, pre-determinations, and authorizations for services per insurance guidelines. Evaluates profitability of therapies and communicates issues.

  • Manage work queue to department standards for productivity and quality.

  • Verifies insurance benefits for new patient referrals.

  • Re-verifies insurance benefits for existing patients.

  • Accurately evaluates charge and reimbursement estimates for infusion therapies.

  • Reviews all medical documentation against medical policy and initiates/obtains pre-determination, pre-certification, and authorizations as needed.

  • Follow-up on pending pre-certifications and/or pre-determinations until outcome decided.

  • Updates and maintains insurance and authorization information in billing software.

  • Obtains PCP referrals as needed.

  • Completes special projects as assigned.

  • Performs other job-related duties as assigned.


Qualifications/Requirements

  • Two or more years of related experience in a healthcare industry; intake/patient access experience.

  • Experience with infusioninjectable medication prior authorizations

  • Must be able to communicate effectively, both orally and in writing.

  • Must demonstrate an understanding of reimbursement practices including government program regulation and managed care contracting

  • Experience working in, and managing changing priorities, in a high volume, fast-paced work environment.

  • Excellent personal computing skills and a working knowledge of MS Office software

  • Maintains clear communication with customers regarding mutual expectations. Takes personal responsibility and accountability for correcting customer-service problems.
    Additional Knowledge and Skills

  • Ability to work well as part of a collaborative team as well as independently.

  • EPIC EMR Experience

  • High School diploma or equivalent




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