Benefit Verification Specialist

4 weeks ago


Oconomowoc, United States Rogers Behavioral Health Full time

The Benefit Verification Specialist is responsible for verifying patient benefit coverage with the facility, ensuring accurate data entry in the system. He/she/they reports to the manager of patient access.

Job Duties & Responsibilities:
Verify insurance benefits on patients and potential patients.
- Place phone calls to insurance/managed care companies regarding patient benefit information and authorization requirements, as required.
- Use online insurance/managed care portals to obtain patient benefit information and authorization requirements, as required.
- Use facility resources and managed care grids to accurately receive, interpret and document benefit quotes provided by insurance/managed care companies.
- Accurately document quote of benefits from insurance/managed care companies in Cerner, selecting appropriate dropdown options, assigning to follow-up worklists as needed, and entering details in necessary fields.
- Audit demographic/insurance/financial data in Cerner, ensuring accuracy for encounters.
- Calculate and document deposits for admissions, as applicable.
- Communicate with admissions and utilization review teams to ensure accuracy of accounts, including requests to collect and input current policy information.
- Knowledge of Rogers programs and the facility’s admission, insurance authorization, and billing processes.
- Provide insurance training or resources to team members, as needed.
- Use good communication skills and tact to deal effectively with third-party carrier representatives, professional staff members, Hospital management, and employees.
- Use common sense in situations and respond appropriately in all communication modes (body language, verbal) to each patient, regardless of his/her/their behavior.
- Maintain a calm attitude and create a conducive atmosphere in difficult situations.
- Work cooperatively and supportively with Hospital staff.
- Remain courteous and respectful to others during work interactions and be willing to work out problems on a one-on-one basis.
- Complete assignments and documentation on time.
- Take responsibility for and manage day-to-day problems, including completion of all documents.

Additional Job Description:
Education/Training Requirements:

- High school diploma required.
- Computer skills required, including word processing.
- Professional experience related to insurance and/or billing is strongly preferred.


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