Patient Benefits Coordinator
4 days ago
The GastroIntestinal Associates, SC is seeking a skilled Patient Benefits Specialist to join our team. This rewarding role offers a unique opportunity to make a difference in the lives of patients by ensuring seamless insurance coverage and benefits.
About the RoleThis position requires strong communication and interpersonal skills to effectively coordinate with patients, staff, and healthcare providers. As a Patient Benefits Specialist, you will be responsible for obtaining pre-authorizations, verifying insurance eligibility, and informing patient account representatives of new or different insurance plans.
Key Responsibilities- Obtain pre-authorizations/pre-certifications as required by health insurers or managed care providers for upcoming procedures, radiology or diagnostic testing, laboratory or other special testing.
- Work with reception and clinical staff to coordinate referrals to outside facilities or providers.
- Verify Medicare, Medicaid, and health insurance eligibility prior to upcoming services and procedures.
- Contact patients prior to appointment or procedure to discuss insurance coverage and benefits and patient financial responsibility.
- Inform patient account representatives of new or different insurance plans for patients, in case claims need to be resubmitted to the correct payer.
- Work with clinical staff to manage appointment frequency, insurance coverage, and benefits for patients on infusion therapy.
- Maintain up-to-date knowledge of clinical guidelines, precertification requirements, and medical policies for services and procedures by routinely reviewing payer newsletters, regulatory and payer websites, and professional periodicals.
- Act as administrator for the insurance websites and obtain and maintain logon access to all payers' websites.
- Education: High school diploma or equivalent required.
- Licensure/Certification: Advanced training/certification in medical billing, coding, and/or insurance preferred.
- Experience: Minimum of one-year experience in a medical billing role is required, or equivalent education.
- Knowledge: Working knowledge of medical and insurance terminology, basic knowledge of CPT, HCPCS, and ICD-10 coding.
- Skills: Interpersonal, communication, and listening skills necessary to deal effectively and courteously with patients and staff members. Proficient computer skills working in an Electronic Medical Record (EMR) and Practice Management software, Microsoft Word, Excel, and the Internet.
- Abilities: Maintain strict confidentiality of fiscal and health information, work in a fast-paced environment, and cope with rapidly changing demands while working as a team member.
$45,000 - $60,000 per year.
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