INSURANCE BENEFITS SPECIALIST
This position is responsible for verifying patient insurance coverage and providing information to patients and other departments within the company. The expectation of this position is to provide a first class service experience, with every patient/or physician interaction.
- Fluently works in Brightree computer system to perform daily job duties.
- Verifies patient insurance coverage, to ensure sleep studies and DME (durable medical equipment) services are covered by
- Re verifies benefits when required.
- Provides pertinent information to patients regarding their benefit coverage.
- Provides same day authorization as per company policy.
- Contacts patient if insurance is terminated.
- Assists patients by discussing different financing options to fit their budgets and makes recommendations.
- Obtains authorization for CPAP rental supplies.
- Authorizes follow up visits from insurance provider.
- Confirms that authorizations are received and entered on sales orders for sleep studies and CPAP setups.
- Ensures all related price quotes given to patients are appropriate and meet current company pricing policy.
- Provides basic information to patients on OSA and answers general question on OSA.
- Responsible for keeping all patient details and information orderly, confidential, current and HIPAA compliant at all times
- Must be knowledgeable in Patient Rights and Responsibilities
- General clerical duties such as filing, photo copying, data entry, scanning as assigned.
Strong commitment to patient care, customer service, friendly, helpful and caring nature is required. Strong level of product knowledge
Education and/or Experience
HS degree or equivalent required. Experience with 2-3 years in insurance verification & benefit authorization. Knowledge of PPO, HMO, government health plans and regulations. A strong understanding of the authorization process and DME (Durable Medical Equipment) experience preferred.
Excellent oral and written communication skills. Ability to interface with employees and vendors in a polite and professional manner, in all levels of the organization from employees to top-level management. Ability to read, analyze, and interpret contracts & technical procedures. Ability to write reports, business correspondence, and procedure manuals. Ability to effectively present information and respond to questions from groups of managers, employees, and the general public. Must be able to communicate clearly and accurately in the English language.
Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percentages.
Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions and situations furnished in written, oral, diagram, or schedule form.
Certificates, Licenses, Registrations
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The position generally involves sitting, ability to lift 20 pounds from a squatting to standing position,bending and reaching, occasional kneeling, twisting, keyboard, telephone operation and operation of office machinery and equipment.
The work environment described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The duties and responsibilities are generally performed in an office environment. The noise level in the work environment is usually moderate.