Position Details:
Industry: Medical Device
Job Title: Customer Service / Verification of benefits
Location: Orlando, FL
Duration: 06 months
Pay range: $18-$21/hr
THIS IS NOT A CUSTOMER SERVICE ROLE. THIS IS A VERIFICATION OF BENEFITS ROLE SO FOCUS ON THIS ASPECT OF THE ROLE.
- 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 Qualifications
- 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 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 Connected Health.
Preferred Qualifications
- Associate’s Degree Preferred
- Knowledge in Medical Insurance
- Knowledge in Contracting and Fee Schedules
- Strong Computer/Software Skills
