Verification of Benefits Specialist

Duties and Responsibilities

Duties and Responsibilities will include, but may not be limited to:

• Obtains patients’ insurance information and contacts carriers to qualify coverage for mental health and/or substance abuse treatment healthcare
• Liaises with insurance carriers to understand each patients’ procedure-specific coverage, revenue codes, and covered levels of care
• Liaises with accounts (facilities) and explains extent of procedure/treatment coverage or lack thereof
• Maintains friendly relationships with all stakeholders: insurance carrier contacts, accounts, and patients
• Relays health insurance benefit information to accounts (facilities) and patients when applicable
• Utilizes the online portals to obtain supplemental benefit information
• Determines deductibles and co-insurance information on the patient’s policy
• Daily data entry; meticulous entry of patient and benefit information into company’s insurance system
• Thoroughly completes the appropriate Verification of Benefits forms; obtains a reference number for the call; and communicates results of the VOB procedure to appropriate teams (internal and external)
• Supports patients with payment arrangements for services not covered by their insurance policies; provides reimbursement rates and discusses different financing options to fit their budgets

Minimum Requirements

KNOWLEDGE

• High school diploma required; college degree preferred
• Two years’ experience in hospital admissions or hospital billing, OR two years’ experience working directly with healthcare insurance carriers
• Working knowledge of medical billing terminology
• Working knowledge of different types of health insurance coverage and policies
• Familiar with EMR (electronic medical records) systems
• Proficient with MS Office Suite (word processing, email, etc.)

SOFT-SKILLS

• Enjoys working in a collaborative environment
• Works with a sense of duty – values strong attention to detail
• Works with a sense of urgency as these documents are often time-sensitive
• Ability to multitask, prioritize, and remain organized
• Excellent interpersonal skills and strong communication
• A desire to help people in a meaningful way