Benefit Verification Specialist

EyeSouth Partners•Houston, TX

About The Position

Join Houston Retina Associates At Houston Retina Associates, we’re more than a leading ophthalmology practice—we’re a team dedicated to preserving and restoring vision for our patients. Specializing in advanced care for retinal conditions like macular degeneration, diabetic retinopathy, and retinal detachment, we combine cutting-edge technology with compassionate, personalized treatment. Our culture is built on collaboration, innovation, and continuous learning. We value every team member’s contribution and provide opportunities for professional growth in a supportive environment. With multiple locations across the greater Houston area, we’re proud to serve our community and make a meaningful impact every day. If you’re passionate about excellence in patient care and want to be part of a team that truly makes a difference, we invite you to join our team! Houston Retina Associates is affiliated with EyeSouth Partners' premier network of medical and surgical specialty eye care services. 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. Applicants who live and plan to work from the following states will not be considered at this time: Alaska, Arizona, California, Colorado, Delaware, Hawaii, Idaho, Montana, Maryland, Massachusetts, Michigan, Nevada, New Mexico, Oregon, New Hampshire, New Jersey, Utah, New York, Rhode Island, Washington, and Wyoming. Thank you for your interest.

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.