Resident Benefits Specialist

Dove Healthcare•Eau Claire, WI

4d•Onsite

About The Position

The Resident Benefits Specialist is responsible for verifying payer sources and coordinating insurance benefits for prospective and newly admitted residents. This position plays a critical role in ensuring accurate, expeditious benefit verification, securing insurance authorizations, and supporting a smooth financial admission process for residents and families. The Resident Benefits Specialist works closely with admissions, clinical teams, and insurance providers to validate coverage, obtain required authorizations, and ensure timely communication with residents and families regarding financial responsibilities.

Requirements

Basic knowledge with insurance verification, healthcare benefits, or billing
Excellent communication and customer service skills
High attention to detail and organizational skills
Ability to manage multiple tasks in a fast-paced environment
Proven experience in administrative or healthcare-related roles
Strong communication and customer service skills, with the ability to interact professionally with residents, families, and staff
Proficiency with computer systems and accurate data entry

Nice To Haves

Advanced knowledge with insurance verification, healthcare benefits, or billing
Background in long-term care, healthcare admissions, or case management
Knowledge of Medicaid and Medicare eligibility and processes

Responsibilities

Verify insurance benefits, eligibility and coverage details
Communicate with insurance providers, payers, and internal teams
Assist with prior authorizations and coverage determinations
Collaborate with admissions and billing teams to ensure smooth service delivery
Review and confirm secondary insurance coverage where applicable.
Communicate with residents, families, and internal staff regarding Medicaid application status, requirements and documentation needs.
Maintain ownership of the insurance authorization process, including:
Obtaining prior authorizations for admissions when required.
Communicate authorization status to the clinical team, admissions staff, and leadership.
Serve as a key contact for insurance verification and authorization questions.
Communicate clearly with residents, families, referral sources, and internal team members regarding benefit coverage and financial responsibilities.
Collaborate with admissions, MDS, therapy, and billing teams to ensure accurate payer setup and coverage coordination.
Maintain accurate documentation of benefit verifications and authorization information in facility systems.
Utilize electronic systems and payer portals to verify benefits and manage authorizations.
Ensure compliance with facility policies and payer requirements.

Benefits

choose your own health insurance - our benefit design offers the flexibility to choose the plan that works best for you and your family!
company paid life and AD&D insurance
dental and vision Insurance
wellness incentives, including onsite gyms, health club reimbursement, weight loss program reimbursement
supplemental benefits, including short-term disability, life insurance, critical illness, accident coverage, hospital indemnity, cancer
paid time off (PTO)
floating holiday
employee assistance program (EAP)
early wage access through DailyPay
childcare assistance - up to 20%
401k, with company match
financial planning resources
referral bonus - up to $700 per referral
tuition reimbursement / scholarship opportunities
continuing education
career mapping