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EyeSouth Partners · 1 day ago

Benefit Verification Specialist

San Antonio, TX

Full-time

Onsite

Entry Level

1+ years exp

EyeSouth Partners is an eye care physician services organization committed to partnering with leading physicians to build a premier network of eye care services throughout the Southeast. The Benefits Verification Specialist will verify patient-specific benefits by contacting insurance companies, document coverage details, and assist in the prior authorization process to ensure patient access to services.

Health CareMarketingProfessional Services

Responsibilities

Collects and reviews all patient insurance information needed to complete the benefit verification process for multiple entities

Verifies patient specific benefits and precisely documents specifics for various payer plans including patient coverage, cost share, and access/provider options according to Program specific SOPs

Verification process could include electronic validation of pharmacy coverage and medical eligibility

Identifies any restrictions and details on how to expedite patient access

Could include documenting and initiating prior authorization process, claims appeals, etc

Completes quality review of work as part of finalizing product

Reports any reimbursement trends/delays to supervisor

Performs related duties and special projects as assigned

Ability to work in a fast-paced office environment

Contributes to the team effort by completing other tasks/projects as needed

Qualification

Benefits verification experienceElectronic medical records (EMR/EHR)Microsoft OfficeInterpersonal skillsOrganizational skillsAttention to detailTeam player

Required

Minimum of one year of healthcare facility, provider, or payer benefits verification experience or another related field or equivalent experience required

Prior electronic medical records experience required (EMR/EHR)

Must possess strong ethics and a high level of personal and professional integrity

Intermediate computer skills including Microsoft Office (preferably Word and Excel)

Excellent interpersonal skills including the ability to interact effectively and professionally with individuals at all levels; both internal and external

Exercises sound judgment in responding to inquiries; understands when to route inquiries to next level

Self-motivated with strong organizational skills and superior attention to detail

Work requires focus, flexibility, and the ability to adapt to changing work situations

Team player that develops strong collaborative working relationships with internal partners and can effectively engage and ability to build consensus among cross-functional teams