Verification of Benefits Specialist

8 hours ago

Lake Mary, Florida, United States Collins Consulting Full-time
100% onsite

Must have prior authorization/verification experience.

Job Duties:
  • Contacts insurance companies to verify insurance benefits.
  • Initiates Pre-authorization, PCP referral, and Letter of Agreement requests for new and ongoing services with insurance companies and performs follow up activities for an outcome.
  • Files Appeals for denied coverage to insurance companies as needed.
  • Maintains customer records in practice management system related to benefit coverage, coordination of benefits, authorizations, denials, appeals, outcomes and communication with insurance company.
  • Coordinates and communicates with other departments as needed to obtain necessary information to complete benefit verification, authorization, appeals and outcomes for services of care.
  • Provides customers with information that includes but is not limited to: updates on status of authorizations, developing & communicating patient financial responsibility estimates, and collecting co-pays, if applicable.
  • Applies knowledge of company procedures, contracted and non-contracted guidelines to process cases accordingly and to respond to incoming correspondence and documentation as well as updating customer records according to outcomes.
  • Performs other related duties as assigned.
Skills:
  • Understanding of Medicare rules and regulations
  • Understanding of managed care as it relates to benefits and authorizations
  • Advanced MS Office experience
  • Strong verbal and written communication skills
  • Must have prior authorization/verification experience.
  • Preferred two or more years’ experience, but a minimum of 1 year experience is required in insurance benefits verification and/or collections and/or managed care contracting.
  • Excellent verbal and written communication skills, including ability to effectively communicate with internal and external customers.
  • Must be able to work under pressure and meet deadlines
Education:
  • Min. HS diploma or GED equivalent