Benefits Specialist from Collabera

Initiates Pre-authorization, PCP referral and Letter of Agreement 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.

High school diploma or GED required

Preferred two or more years’ experience, but a minimum of 1 year experience is required in insurance benefits verification and/or collections and/or managed care contracting.

Excellent verbal and written communication skills, including ability to effectively communicate with internal and external customers.

Must be able to work under pressure and meet deadlines, while maintaining a positive attitude and providing exemplary customer service

Ability to work independently and to carry out assignments to completion within parameters of instructions given, prescribed routines, and standard accepted practices

Understand the process for verification of benefits or collections as it relates to the policies and procedures for effective placement of medical services.

Complete Understanding of Medicare Rules and Regulations

Understanding of Managed Care as it relates to benefits and authorizations

Advanced Office Suite experience, with an emphasis on Excel desired