Benefit Verification Specialist

Job Duties & Responsibilities:

Verify insurance benefits on patients and potential patients.

• Place phone calls to insurance/managed care companies regarding patient benefit information and authorization requirements, as required.
• Use online insurance/managed care portals to obtain patient benefit information and authorization requirements, as required.
• Use facility resources and managed care grids to accurately receive, interpret and document benefit quotes provided by insurance/managed care companies.
• Accurately document quote of benefits from insurance/managed care companies in Cerner, selecting appropriate dropdown options, assigning to follow-up worklists as needed, and entering details in necessary fields.
• Audit demographic/insurance/financial data in Cerner, ensuring accuracy for encounters.
• Calculate and document deposits for admissions, as applicable.
• Communicate with admissions and utilization review teams to ensure accuracy of accounts, including requests to collect and input current policy information.
• Knowledge of Rogers programs and the facility's admission, insurance authorization, and billing processes.
• Provide insurance training or resources to team members, as needed.
  

Apply good practice principles to job duties.

• Use good communication skills and tact to deal effectively with third-party carrier representatives, professional staff members, Hospital management, and employees.
• Use common sense in situations and respond appropriately in all communication modes (body language, verbal) to each patient, regardless of his/her/their behavior.
• Maintain a calm attitude and create a conducive atmosphere in difficult situations.
• Work cooperatively and supportively with Hospital staff.
• Remain courteous and respectful to others during work interactions and be willing to work out problems on a one-on-one basis.
• Complete assignments and documentation on time.
• Take responsibility for and manage day-to-day problems, including completion of all documents.

Additional Job Description:

Education/Training Requirements:

• High school diploma required.
• Computer skills required, including word processing.
• Professional experience related to insurance and/or billing is strongly preferred.