Abbott · 13 hours ago
SME, Verification of Benefits
Lake Mary, FL
Full-time
Onsite
Entry, Mid Level
$20.85/hr - $41.75/hr
2+ years expAbbott is a global healthcare leader that helps people live more fully at all stages of life. As the SME Verification of Benefits, you will assist patients in verifying their insurance information and collecting necessary authorizations to ensure they receive appropriate care.
BiotechnologyEmergency MedicineGeneticsHealth CareHealth DiagnosticsManufacturingMedicalMedical DeviceNutritionPharmaceutical
Responsibilities
Contacts insurance companies to verify status of customer benefits
Files pre-authorizations for new and ongoing services with insurance companies and follow up for an outcome
Files Appeals to insurance companies as needed
Gathers all necessary documents as requested by insurance companies
Maintains customer records in practice management system related to 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 regarding their status, which may include : developing financial breakdowns for the patient, giving the patient estimates of costs and collecting co-pays, if applicable
Assist in coordination of Single Case Agreements for non-contracted plans
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
Assist employees in understanding tasks and department processes and workflow
Organize and distribute daily tasks as needed
Provides feedback to management regarding department tools , workflow and payer outcomes that impact department processes and handling
Work with Quality and Process team on department tools and work instructions
Assists with employee on boarding and ongoing training
Assists or leads department projects
Point of contact to assist other departments on escalated issues or reported incidents or raise to management
Performs other related duties as assigned
Qualification
Required
High School diploma or GED required
Two or more years' experience in VAD insurance benefits verification and prior authorizations
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 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 MS Office experience, with an emphasis on MS Excel desired
Continued Self Improvement courses & seminars related to position along with 'In House' programs provided by Acelis Connected Health/Abbott
Preferred
Associate's Degree preferred
Knowledge in Contracting and Fee Schedules
Strong Computer/Software Skills
Benefits
Free medical coverage in our Health Investment Plan (HIP) PPO medical plan
Excellent retirement savings plan with a high employer contribution
Tuition reimbursement
Freedom 2 Save student debt program
FreeU education benefit - an affordable and convenient path to getting a bachelor’s degree
Company
Abbott
Abbott is a healthcare company that produces diagnostic kits, medical devices, nutritional products, and branded generic medicines.
10001+ employees
Funding
Current Stage
Public CompanyTotal Funding
$6.79M2011-03-15Post Ipo Debt· $0.1M
2009-03-16Post Ipo Debt· $6.69M
1980-12-12IPO
Leadership Team
Robert Ford
President & Chief Executive Officer
Mike Peterson
Senior Vice President
Recent News
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