Benefits Specialist

United Medical Inc.; Virginia Beach (VA); On-site; USD 45,000 - 60,000; Full time

Job summary

United Medical Inc. is seeking a Benefits Specialist to manage the administration and processing of durable medical equipment for patients. The role involves handling benefit inquiries, referral documents, and out-of-pocket costs while collaborating with internal and external clients.

Strong interpersonal skills and healthcare billing knowledge are essential. The position requires at least 2 years in the DME/HME field, attention to detail, and the ability to work in a fast-paced environment.

Qualifications

• Minimum 2 years of experience in the DME/HME industry.
• Ability to communicate clearly with patients, physicians and staff.
• Ability to analyze information and resolve problems promptly.
• Strong understanding of insurance guidelines and reimbursement practices.
• Knowledge of healthcare billing codes (CPT, ICD-10, HCPCS).

Responsibilities

• Process patient orders for durable medical equipment accurately and timely.
• Respond to benefit inquiries and provide patients with out-of-pocket costs.
• Educate patients on financial responsibilities of their DME orders.
• Review incoming medical documentation for billing accuracy.
• Schedule patients for upcoming appointments.
• Assist with questions on insurance policies and coverage determinations.
• Stay updated on healthcare regulations and compliance requirements.
• Communicate effectively with internal and external stakeholders.
• Participate in weekly department meetings and training.

Skills

Microsoft Office

Communication skills

Billing and coding (CPT/ICD-10/HCPCS)

Interpersonal skills

Problem solving

Multitasking

Data entry accuracy

Insurance policy knowledge

Tools

Insurance portals

Billing systems

Job description

Description:

The Benefits Specialist is responsible for the administration and processing of durable medical equipment supplies for each patient’s orders. The administration of each order includes responding to benefit inquiries, processing referral documentation, requesting additional documents, and providing patients with all out of pocket costs related to their order. This role requires collaboration with both internal and external clients, and the candidate must have strong interpersonal skills.

Responsibilities and Duties:

Understand that you need to be at the office by 9 am Monday-Friday and work a minimum of 36 hours each week.

Role includes but is not exclusive to:

• Ensure all patient orders are processed timely and accurately to enhance patient satisfaction and reduce order cycle time
• Provide both patients and physicians or therapists with benefit inquiry responses
• Educates patients as to the financial responsibility associated with their DME
• Review and analyze all incoming medical documentation for ordering/billing accuracy
• Scheduling patients for upcoming appointments
• Handle any questions regarding insurance policies, coverage determinations, and allowable for all the insurance we work with to provide excellent customer service
• Stay updated on healthcare regulations and compliance requirements
• Communicate effectively with internal and external stakeholders
• Participate in all weekly departmental meetings and training sessions
• Complies with all regulatory requirements such as OSHA, HIPPA, Compliance and other requirements that may be mandated

Performs other duties as specified by the leadership team. This position can be fluid and may need adjustments and deletion of processes to keep up with the changing environment.

Environmental Working Conditions and Physical Requirements:

• Sitting in a seated position for extended periods of time
• Finger dexterity is required to manipulate small objects such as using a keyboard.
• Communication skills using the spoken word, both in person and over the telephone.
• Visual ability to read materials in either a printed format or on a computer screen.
• Ability to hear well enough to carry on a normal conversation, both in person and over the telephone.
• Stamina to maintain attention to detail despite frequent interruptions
• Ability to lift 50 pounds.
• Possess basic mechanical skills, especially those related to troubleshooting respiratory equipment.
• Ability to work in all weather.

Qualifications:

• Minimum of 2 years of experience in DME/HME industry, with a basic understanding of intake documentation, billing, compliance, and medical terminology.
• Ability to effectively communicate, orally and in writing, with the public and with employees to exchange and clarify information
• Ability to identify and resolve problems in a timely manner while analyzing the information and data
• Strong understanding of insurance guidelines and reimbursement practices
• Knowledge of healthcare billing codes (CPT, ICD-10, HCPCS)

Skill requirements:

• Proficient computer skills and ability to navigate Microsoft office, internal computer systems, insurance portals, and process payments
• Excellent organizational and time management skills with the ability to prioritize tasks as needed
• Possess a high level of attention to detail when typing and entering information into systems and databases
• Role requires use of frequent basic math skills
• Developing and maintaining good relationships with co-workers and managers.
• Maintaining open lines of communication with others
• Ability to multitask and meet deadlines
• Flexibility to adapt in a fast-paced environment that is constantly evolving