As the Verification of Benefits Specialist, you’ll have the chance to assist our patients in having accurate insurance information on file and collecting of authorizations or PCP referrals as needed.Principle ResponsibilitiesThe following reflects management’s definition of essential functions for this job, but does not restrict the tasks that may be assigned. Management may assign or reassign duties and responsibilities to this job at any time due to reasonable accommodation or other reasons.Must have prior authorization experience.Contacts insurance companies to verify insurance benefits.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.Performs other related duties as assigned.Required QualificationsHigh school diploma or GED requiredPreferred 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 serviceAbility to work independently and to carry out assignments to completion within parameters of instructions given, prescribed routines, and standard accepted practicesUnderstand 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 RegulationsUnderstanding of Managed Care as it relates to benefits and authorizationsAdvanced MS Office experience, with an emphasis on MS Excel desiredContinued Self Improvement courses & seminars related to position along with “In House” programs provided by client.Preferred QualificationsAssociate’s Degree PreferredKnowledge in Medical InsuranceKnowledge in Contracting and Fee SchedulesStrong Computer/Software SkillsPhysical RequirementsMust be able to work at a computer workstation for extended periods of timeNotes:08:00 AM - 04:30 PMVIVA is an equal opportunity employer. All qualified applicants have an equal opportunity for placement, and all employees have an equal opportunity to develop on the job. This means that VIVA will not discriminate against any employee or qualified applicant on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.
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