Estimate/Benefits Coordinator

Orthopaedic & Spine Center of the Rockies•Fort Collins, CO

6h•Onsite

About The Position

The Estimate/Benefits Coordinator position performs various routine procedures associated with patient insurance eligibility and benefits. Estimate/Benefits Coordinator works closely with their Team Lead/Manager in obtaining a concise understanding of the rules and regulations for various insurance companies. This position also determines patient out-of-pocket estimates based on the patient's specific insurance plan.

Requirements

High School Diploma or equivalent, required.
Proven speed and accuracy in data entry and 10-key procedures.
Strong organizational and communication skills required.
Core competencies in quality, detail oriented, planning/organizing, communication, teamwork, and confidentiality.

Nice To Haves

Two to four years of experience in the insurance or medical industry or equivalent experience in a business/accounting department preferred. Education may be substituted for experience.

Responsibilities

Contacts insurance carriers regarding the eligibility of patient benefits for scheduled procedures while ensuring verification and any benefit issues are handled prior to the ordered date(s).
Works closely with the Authorization Coordinator team to develop a thorough understanding of insurance benefits to determine patient eligibility.
Determines patient out-of-pocket estimates based on the patient's specific insurance plan.
Notifies patients of determined expenses and establishes payment arrangements per OCR guidelines and department protocols.
Works directly with assigned OCR physician clinics as issues and/or questions arise.
Ensures that daily bookkeeping tasks (e.g., all data entry, account notes, procedure cases, etc.) are completed in an accurate and timely manner.
Demonstrates a basic knowledge of all participating insurance companies and insurance plans.
Obtains required insurance information from patients and/or co-workers as needed in order to complete assigned tasks.
Provides prompt support for check-in/out personnel regarding insurance eligibility issues at the time the patient is present in the clinic. This may include answering questions over the phone, meeting with patients, or following up with insurance carriers.
Maintains complete, accurate and up-to-date notes in patient accounts regarding benefits and pre-authorizations.
Works up cash estimates for procedures after it is determined the patient is not eligible for benefits through an OCR approved insurance carrier.
Assists Authorization Coordinators with work overflow tasks as needed.
Communicates all concerns, risk management issues, breakdown in protocol and constructive criticisms to supervisor. Follows chain-of-command established by supervisor when addressing protocol issues outside of the Business Office service line.
Maintains a clean and orderly work area including personal area, computer room and record storage area.
Required to follow OCR and departmental policies and procedures.
Other duties as assigned.