Benefits Specialist

Reliable Respiratory; Shrewsbury (MA); Hybrid; USD 45,000 - 65,000; Full time

Job summary

Reliable Respiratory is seeking a Benefits Specialist to manage patient insurance data and eligibility, updating records in the EHR and coordinating with payors to ensure successful claim payment. The role emphasizes exceptional service to patients, families, payors, providers, and teammates within a hybrid work model.

Candidates must be eligible to work in the United States, be 18+, and have an Associate’s degree or 2 years of related experience, with a two-days-in-office, three-days-remote

Qualifications

• Must be eligible to work in the United States
• 18 years of age or older
• Associate’s degree required or 2 years of relevant experience
• Ability to maintain a hybrid work schedule - 2 days in office, 3 days work from home

Responsibilities

• Provide exceptional service every time.
• Meet or exceed annual performance indicators as outlined by organizational leadership.
• Complete assigned tasks and worklists in a timely manner.
• Update patient demographics and ensure patient charts are up to date and accurate.
• Update patient insurance policies in Reliable Respiratory’s electronic health record system and task the associated team to update any renting sales orders, existing prior authorizations and/or CMNs (Certificate of Medical Necessity).
• Verify patients’ insurance eligibility, including contacting payors to investigate and verify the terms and benefits of patients’ insurance policies and costs.
• Work with team to maintain the process document to verify in-network and out of network insurances for billable HCPC and procedure codes.
• Handle incoming communications from customers and referrers in a timely, professional, and friendly manner.
• Comply with all policies and procedures established by the company and the company's regulatory bodies.
• Actively participate in meetings as necessary.
• Perform other duties and special projects as assigned and directed

Skills

Problem solving

Communication

Customer service

Attention to detail

Microsoft Office

Independent worker

Team collaboration

Education

Associate’s degree

Tools

Microsoft Office Suite

Job description

Equal Opportunity Employer/Disability/Veterans

Benefits Specialist

Candidates must reside within commuting distance of one of our office locations, as this is a hybrid position requiring two days per week in the office and three days per week working remotely.

About Reliable Respiratory

Reliable Respiratory is a Durable Medical Equipment (DME) company that provides the highest quality level of service for patients in need of respiratory, diabetes, urology, and maternity support. Equipment provided includes, CPAPs, BiPAPs, AutoPAPs, nebulizers, oxygen equipment, ventilators, CGM devices, insulin pumps, and breast pumps.

Each patient is treated with professionalism, understanding, and attentive service. We care about our customers, work closely with the medical community, and have highly skilled staff ready to assist customers in receiving the best care possible.

Job Purpose

The Benefits Specialist is responsible for updating the Patient’s insurance and demographic information in Reliable Respiratory’s electronic health record system and obtaining benefits and eligibility information from the insurance company to achieve successful payment of claims. The Benefits Specialist will also provide exceptional service to our patients and their families, payors, providers and team members.

EEO-1 Job Classification– Administrative Support Workers

Duties and Responsibilities

• Provide exceptional service every time.
• Meet or exceed annual performance indicators as outlined by organizational leadership.
• Complete assigned tasks and worklists in a timely manner.
• Update patient demographics and ensure patient charts are up to date and accurate.
• Update patient insurance policies in Reliable Respiratory’s electronic health record system and task the associated team to update any renting sales orders, existing prior authorizations and/or CMNs (Certificate of Medical Necessity).
• Verify patients’ insurance eligibility, including contacting payors to investigate and verify the terms and benefits of patients’ insurance policies and costs.
• Work with team to maintain the process document to verify in-network and out of network insurances for billable HCPC and procedure codes.
• Handle incoming communications from customers and referrers in a timely, professional, and friendly manner.
• Comply with all policies and procedures established by the company and the company's regulatory bodies.
• Actively participate in meetings as necessary.
• Perform other duties and special projects as assigned and directed

Basic Qualifications

• Must be eligible to work in the United States and not require work authorization from us now or in the future
• 18 years of age or older
• Associate’s degree required or 2 years of relevant (authorization, claims, billing) experience
• Ability to maintain a hybrid work schedule - 2 days in office, 3 days work from home

Required Skills

• Demonstrates effective problem solving.
• Listens attentively to people’s ideas and concerns.
• Makes decisions in a timely manner when the options are clear and there is little pressure or risk.
• Maintains balance through unexpected circumstances.
• Acts without being asked or required to do so.
• Exercises excellent judgment in all aspects of the execution of job duties.
• Effective and professional verbal and written communication abilities.
• Seeks to improve in all aspects of work performance.
• Responds to internal and external inquiries in a timely manner.
• Excellent customer service skills; especially in high intensity situations
• Strong attention to detail.
• Proficient in the use of computer applications (especially Microsoft Office Suite).
• Ability to work independently.
• Ability to work in collaboration with others.
• Ability to prioritize and complete work amidst interruptions in a busy work area.
• Ability to comply with internal and industry-imposed guidelines/regulations

Competencies

• Customer Service
• Ethics
• Organization Skills
• Productivity
• Results Driven
• Computer Skills

Work Environment & Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• While performing the duties of this job, the employee is regularly required to communicate and convey information with the appropriate parties. The job requires assuming a stationary position for long periods of time
• This role routinely uses standard office equipment such as computers, phones, and printers/scanners

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.

• This job operates in a professional office environment
• The noise level in the work environment is usually moderate to loud

Direct Reports – None

Other Duties

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

Reliable Respiratory, INC participates in E-Verify. E-Verify is a web-based system that allows an employer to determine an employee's eligibility to work in the US using information reported on an employee's Form I-9. The E-Verify system confirms eligibility with both the Social Security Administration (SSA) and Department of Homeland Security (DHS). For more information, please go to the USCIS E-Verify website.