Benefits Specialist

W3Global; Virginia Beach (VA); On-site; USD 42,000 - 56,000; Full time

Job summary

W3Global is seeking a Benefits Specialist to manage the administration and processing of durable medical equipment orders. The role involves responding to benefit inquiries, handling referral documents, and communicating patient out-of-pocket costs.

You will collaborate with internal and external clients and must be highly personable. Office presence is required with standard hours, and a minimum of 36 hours per week.

Qualifications

• Minimum of 2 years of experience in DME/HME industry, with knowledge of intake documentation, billing, compliance, and medical terminology.
• Strong communication skills, both written and spoken, with patients and staff.
• Ability to identify and resolve problems promptly while analyzing information and data.
• Solid understanding of insurance guidelines and reimbursement practices.
• Familiarity with healthcare billing codes (CPT, ICD-10, HCPCS).

Responsibilities

• Process patient orders accurately and timely to improve satisfaction and reduce order cycle time.
• Respond to benefit inquiries and provide patients with out-of-pocket cost information.
• Educate patients about financial responsibilities related to DME.
• Review incoming medical documentation for ordering/billing accuracy.
• Schedule patients for upcoming appointments.
• Address questions on insurance policies and coverage determinations.
• Stay updated on healthcare regulations and compliance requirements.
• Communicate effectively with stakeholders inside and outside the organization.

Skills

Microsoft Office

Internal systems

Insurance portals

Attention to detail

Multitasking

Communication

Time management

Problem solving

Collaboration

Tools

Microsoft Office

Insurance portals

Internal computer systems

Job description

About The Job

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.

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

The work environment of the Benefits Specialist involves the everyday risks and discomforts. The Benefits Specialist must be capable of performing the same safe work practices required of the office and field staff. Especially with regards to observance of OSHA regulations. Additionally, you must possess the following attributes:

• 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