Benefits Verification Specialist — Flexible Hours

CareMetx, LLC; United States; Vor Ort; USD 42.000 - 64.000; Vollzeit

Zusammenfassung

CareMetx, LLC is seeking a Benefits Verification Specialist to verify patient benefits with insurance providers for client programs and to document coverage details accurately. The role supports patient enrollment and access to therapy.

You will review insurance information, triage missing data, and document payer specifics to expedite access. Strong data entry, communication, and attention to detail are essential, with collaboration across teams.

Qualifikationen

• Requires a high school diploma or GED with at least 2 years of related experience in customer service, medical billing/coding, benefits verification, healthcare administration, or similar.
• Bachelor's degree preferred; equivalent combination of education and experience will be considered.
• MUST HAVE FUSION/SALESFORCE EXPERIENCE.

Aufgaben

• Review all patient insurance information needed to complete the benefit verification process.
• Triages cases with missing information to appropriate program associate.
• Verify patient benefits and document specifics for various payer plans including coverage and cost share.
• Identify restrictions and expedite patient access.
• Possibly document and initiate prior authorization process and related tasks.
• Perform quality review of work prior to finalizing products.
• Report reimbursement trends/delays to management.
• Complete related duties and projects as assigned.

Kenntnisse

Advanced customer service

Data entry

Analytical skills

Attention to detail

Communication skills

Ausbildung

High school diploma or GED

Bachelor's degree preferred

Equivalent combination of education and experience

Tools

Salesforce

Fusion

Windows

Excel

Outlook

Jobbeschreibung

CareMetx, LLC is seeking a Benefits Verification Specialist to verify patient benefits with insurance providers for client programs and to document coverage details accurately. The role supports patient enrollment and access to therapy.

You will review insurance information, triage missing data, and document payer specifics to expedite access. Strong data entry, communication, and attention to detail are essential, with collaboration across teams.