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Benefit Verification Specialist

3 months ago

Bellaire Texas, United States Retina & Vitreous of Texas Full time

Company Overview:


At Retina & Vitreous of Texas, our retina specialists realize that medicine is multi-faceted and focus on providing the best personalized treatment to our patients and do so with state-of-the-art technology in a compassionate and attentive environment.

Our physicians are board certified ophthalmologists by the American board of Ophthalmology and completed an additional two-year vitreoretinal surgical fellowship in diseases of the retina, macular, and vitreous.

With six MD's and eleven offices in the Houston, TX area we have an ongoing mission to always deliver the best possible care.


Position Summary:
The Benefits Verification Specialist will contact insurance companies, on behalf of the physician's office, to verify patient specific benefits.

The Benefits Verification Specialist will ask appropriate questions regarding patient's benefits and complete data entry and/or appropriate forms to document patient's benefits coverage.


Responsibilities:
Collects and reviews all patient insurance information needed to complete the benefit verification process for multiple entities.


Verifies patient specific benefits and precisely documents specifics for various payer plans including patient coverage, cost share, and access/provider options according to Program specific SOPs.

Verification process could include electronic validation of pharmacy coverage and medical eligibility.

Identifies any restrictions and details on how to expedite patient access.

Could include documenting and initiating prior authorization process, claims appeals, etc.

Completes quality review of work as part of finalizing product.

Reports any reimbursement trends/delays to supervisor.

Performs related duties and special projects as assigned.

Ability to work in a fast-paced office environment.

Contributes to the team effort by completing other tasks/projects as needed.

Qualifications:
Minimum of one year of healthcare facility, provider, or payer benefits verification experience or another related field or equivalent experience required

Prior electronic medical records experience required (EMR/EHR)

Must possess strong ethics and a high level of personal and professional integrity

Intermediate computer skills including Microsoft Office (preferably Word and Excel)

Excellent interpersonal skills including the ability to interact effectively and professionally with individuals at all levels; both internal and external

Exercises sound judgment in responding to inquiries; understands when to route inquiries to next level.

Self-motivated with strong organizational skills and superior attention to detail

Work requires focus, flexibility, and the ability to adapt to changing work situations.

Team player that develops strong collaborative working relationships with internal partners and can effectively engage and ability to build consensus among cross-functional teams

Company Benefits:
We offer a competitive benefits package to our employees:

Medical

Dental

Vision

401k w/ Match

HSA/FSA

Telemedicine

Generous PTO Package

We also offer the following benefits for FREE:
Employee Discounts and Perks

Employee Assistance Program

Group Life/AD&D

Short Term Disability Insurance

Long Term Disability Insurance

EyeSouth Partners is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.