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Verification of Benefits Specialist

Spectraforce Technologies
United States, Florida, Orlando
May 09, 2024
Job Title: Verification of Benefits Specialist Job Location: Orlando, FL 32810 Job Duration: 6 Months Time Schedule: Hours: 8 to 4:30 pm or 8:30 to 5pm with two 15 min breaks and one half-hour lunch break Responsibilities: Person will be doing Verification of Benefits in the Appeals process for prior authorization/denials/exceptions, etc. Lots of paperwork and phone calls. Person MUST come with 1 year of experience and knowledge in Veteran Affairs, Worker Compensation, Medicaid, Medicare Advantage, PPO and Prior Authorization Appeals are all a MUST Top skills to look for: ability to work in a fast paced environment, ability to be adaptable to change, attention to detail, good phone skills/communication skills Contacts insurance companies to verify insurance benefits; initiates pre-authorization requests for new and ongoing services with insurance companies and performs follow up activities for an outcome. Files Appeals for denied coverage to insurance companies as needed; maintains customer records in practice management system related to benefit coverage, coordination of benefits, authorizations, denials, appeals, outcomes and communication with insurance company; coordinates and communicates with other departments as needed to obtain necessary information to complete benefit verification, authorization, appeals and outcomes for services of care. Provides customers with information that includes but is not limited to: updates on status of authorizations, developing & communicating patient financial responsibility estimates, and collecting co-pays, if applicable; applies knowledge of company procedures, contracted and non-contracted guidelines to process cases accordingly and to respond to incoming correspondence and documentation as well as updating customer records according to outcomes; performs other related duties as assigned. Must Have: Min. 1 yr. Knowledge of VA, Workers Comp, PA Appeals is a must Skills Understanding of Medicare rules and regulations Understanding of managed care as it relates to benefits and authorizations; advanced MS Office experience; strong verbal and written communication skills. Education: HS diploma or GED equivalent