Insurance Benefits Verification Specialist, RCM

Mayfield Clinic, Inc.; Cincinnati (OH); On-site; USD 42,000 - 56,000; Full time

Job summary

Mayfield Clinic, Inc. is seeking an Insurance Benefits Verification Specialist to join the Revenue Cycle Management team. The role focuses on verifying insurance eligibility and benefits, estimating costs, and handling patient account follow-up.

The ideal candidate has healthcare administration/RCM experience and strong communication skills. The position requires attention to detail, the ability to learn quickly, and a collaborative mindset to support a dynamic healthcare environment in

Qualifications

• High School Diploma required.
• Two years of experience in healthcare administration/revenue cycle.
• CRCR Certification preferred.

Responsibilities

• Execute actions on patient account details, including insurance eligibility and benefits verification.
• Perform cost estimation and pre-collect on scheduled services.
• Register new patients and prepare payment plans.
• Pursue payment and resolve questions in a timely, professional manner.
• Maintain accurate posting of patient payments and update the practice management system.

Skills

Customer service

Empathy

Problem-solving

Multi-tasking

Communication

Stress management

Diplomacy

Team oriented

Software proficiency

Independent work

Education

High School Diploma

2 years healthcare admin/RCM

CRCR Certification (preferred)

Job description

Career Opportunities with Mayfield Clinic

Current job opportunities are posted here as they become available.

Insurance Benefits Verification Specialist, RCM

This Specialist will join the insurance verification team and be responsible for patient registration and eligibility verification, benefits investigation, cost estimation, and other tasks related to patient account balances. The Revenue Cycle Management (RCM) team is seeking an individual with experience in insurance eligibility and/or claims processing, as well as critical thinking skills, attention to detail, and the ability to learn quickly and adapt to a dynamic environment.

Education/Experience

• High School Diploma required
• Two years of experience in healthcare administration/revenue cycle
• CRCR Certification preferred

Skills

• Demonstrates excellent customer service
• Ability to convey empathy
• Strong problem-solving, problem-prevention, and decision-making skills
• Ability to manage and prioritize multiple tasks in a fast-paced environment
• Excellent oral and written communication skills
• Ability to maintain composure and restore calm in a stressful situation
• Uses good judgment and diplomacy when dealing with others
• Desire and ability to work in a team environment
• Computer proficient with the ability to learn multiple software applications
• Ability to work with minimal supervision

Primary Responsibilities

The purpose of this position is to execute actions on patient account details, including insurance eligibility and benefits verification, cost estimation, answering patient calls, and performing patient account follow-up tasks in the assigned area of the Revenue Cycle process.

Essential Functions

• Help develop &maintain a corporate culture that supports the mission and values of Mayfield Clinic
• Verify patient eligibility and benefits in an accurate, timely manner; prepare cost estimates and pre-collect on scheduled services, register new patients, prepare payment plans, and perform other tasks as required.
• Make all necessary corrections to patient accounts in collaboration with the claims follow-up team.
• Research unpaid patient balances and communicate with patients and 7 clinical office staff as needed to pursue payment. Ensure that questions and requests for information are addressed in a timely & professional manner to ensure resolution & reimbursement.
• Ensure timely & accurate posting of patient payment information, and follow up with patients as needed to ensure full, expected reimbursement for services provided.
• Maintain documentation and update our practice management system for appropriate claims submission & other pertinent information to identify action taken.
• Make necessary adjustments as appropriately required by plan reimbursement & company policy.
• Prioritize accounts based on aging and outstanding dollar amounts or as directed by management.
• Research & initiate requests for refunds for accounts with credit balances.
• Answer & initiate phone inquiries regarding bills, charges, claims, and account status.
• Update data in the practice management system as required.
• Contribute to the team environment by performing other duties as assigned.

Physical Requirements

• Hand Movement, including repetitive motions, grasping, holding, and finger dexterity. Reading, Writing, and Hand-Eye Coordination. Vision, including color distinction, and visual inspection. Hearing, Talking, Sitting, Lifting up to 10 pounds, Bending, Reaching

Mayfield Clinic Mission

To provide the best neurological care for our patients through:

• Superior clinical outcomes
• Education and research

Mayfield Clinic Values

• Integrity: We commit to honest and ethical behavior in all of our endeavors and interactions.
• Excellence: We commit to the highest level of performance and continuous improvement.
• Respect: We embrace the importance of all individuals & value their diverse backgrounds, skills & contributions.
• Compassion: We commit to being compassionate and empathetic in all of our interactions.
• Collaboration: We embrace teamwork, mentoring, cooperation, sharing of expertise, & empowerment.