Verification of Benefits Specialist

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$17.00/hr - $20.00/hr

Job Title: Verification of Benefits Specialist

Location: Plano, TX – Onsite – Local candidates only

Period: 10/28/2024 to 04/27/2025

Hours/Week: 40 hours

Rate: $17-$20/hr

Contract Type: W-2

Scope Of Services

The Verification of Benefits Specialist plays a crucial role in ensuring accurate verification of insurance benefits for patients. This role involves contacting insurance companies to verify insurance benefits, initiating pre-authorization requests for new and ongoing services, and performing follow-up activities to ensure successful outcomes. Additionally, the Specialist handles the filing of appeals for denied coverage, maintains customer records in the practice management system, and coordinates communication with other departments as needed to obtain necessary information for benefit verification, authorization, and appeals.

Role, Responsibilities, And Deliverables

• Contact insurance companies to verify insurance benefits accurately.
• Initiate pre-authorization requests for new and ongoing services and conduct follow-up activities to ensure timely outcomes.
• File appeals for denied coverage with insurance companies when necessary.
• Maintain accurate customer records in the practice management system regarding benefit coverage, authorizations, denials, appeals, and outcomes.
• Coordinate and communicate with other departments to gather necessary information for benefit verification, authorization, appeals, and outcomes.
• Provide customers with information regarding the status of authorizations, patient financial responsibility estimates, and collection of co-pays.
• Apply knowledge of company procedures, contracted and non-contracted guidelines to process cases accordingly, respond to incoming correspondence, and update customer records according to outcomes.
• Perform any other related duties as assigned by the supervisor.

• Minimum high school diploma or GED equivalent required.
• Understanding of Medicare rules and regulations.
• Familiarity with managed care as it relates to benefits and authorizations.
• Advanced proficiency in MS Office applications.
• Strong verbal and written communication skills essential for effective communication with insurance companies and internal departments.

• Seniority level
  
  Entry level

• Employment type
  
  Full-time

• Job function
  
  Information Technology
• Industries Business Consulting and Services

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