Benefit Verification Specialist

EyeSouth Partners•San Antonio, TX

About The Position

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.

Requirements

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

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.