Benefits Verification Specialist

Direct Staffing Inc; Rockville (MD); On-site; USD 23,419; Full time

Job summary

A staffing agency is seeking a Reimbursement Counselor to verify patient benefits by contacting insurance companies. This role requires strong attention to detail, effective communication, and proficiency in Windows applications. Preferred candidates hold a high school diploma and have experience in medical office administration or benefit verification. The position involves data entry, documenting patient coverage, and assisting in prior authorization processes, contributing to streamlined patient access to healthcare services.

Qualifications

• Proficient with data entry/typing in Windows environment.
• Experience in medical office administration or customer service.
• Knowledge of Medicaid, Medicare, and private insurance.

Responsibilities

• Contact insurance companies to verify patient benefits.
• Complete data entry for documenting patient coverage.
• Verify specifics for payer plans and document accurately.
• Assist with prior authorization processes and claims appeals.
• Report reimbursement trends and delays to supervisor.

Skills

Windows based experience

Outlook

Word

Excel

Interpersonal skills

Analytical skills

Attention to detail

Communication skills

Education

High school diploma or GED

Two or more years of related experience

Job description

Job Description

POSITION TITLE: Reimbursement Counselor (Benefits Verification Specialist – BVS)

Payrate: $17 per hr

POSITION SUMMARY

Under close supervision of the project Team Coordinators / Management team, the Benefits Verification Specialist will contact insurance companies, on behalf of the physician’s office, to verify patient specific benefits. The Benefits Verification Specialist will ask appropriate questions regarding patient’s benefits and complete data entry and/or appropriate forms to document patient’s benefits coverage.

PRIMARY DUTIES AND RESPONSIBILITIES

• Collects and reviews all patient insurance information needed to complete the benefit verification process.
• Verifies patient specific benefits and precisely documents specifics for various payer plans including patient coverage, cost share, and access/provider options according to Program specific SOPs.
• Verification process could include electronic validation of pharmacy coverage and medical eligibility.
• Identifies any restrictions and details on how to expedite patient access.
• Could include documenting and initiating prior authorization process, claims appeals, etc.
• Completes quality review of work as part of finalizing product.
• Reports any reimbursement trends/delays to supervisor.
• Performs related duties and special projects as assigned.
• Ability to work in a fast-paced office environment.
• Work requires focus, flexibility, and the ability to adapt to changing work situations.
• This position requires that the Associate be seated most of the day.

Required

• Proficient Windows based experience including fundamentals of data entry/typing.
• Working knowledge of Outlook, Word, and Excel.
• Strong interpersonal skills and professionalism.
• Independent problem solver, good decision maker, and robust analytical skills.
• Strong attention to detail.
• Effective written and verbal communication.

Preferred

• High school diploma or GED minimally required. Two (2)+ years directly related and progressively responsible experience and/or college degree.
• Specific experience in medical office administration, benefit verification, coding, claims processing or customer service at an insurance company a plus.
• Broader experience/training may be considered in fields such as case management, social services and pharmacy technician.
• Familiarity with verification of insurance benefits a plus.
• Fundamental understanding of key payers including Medicaid, Medicare and private payers.

Additional Information

All your information will be kept confidential according to EEO guidelines.