Patient Benefits Specialist

Optioncare; Springfield (IL); On-site; USD 29,000 - 48,000; Full time

Benefits offered by this job

Medical, Dental, & Vision Insurance

401K Retirement Savings Plan with Firm

PTO

Tuition Reimbursement

HSA Company Match

Flexible Spending Accounts

Job summary

Option Care Health in Springfield, IL is seeking an Insurance Verification Specialist to verify benefits, determine patient responsibility, and coordinate authorization for services and testing. This role supports accurate billing and patient intake within the revenue cycle process.

The position requires a High School Diploma with experience in patient registration or revenue cycle, with preferred LPN or Pharm Tech licensure and/or infusion billing experience.

Qualifications

• High School Diploma with 2 years of experience in patient registration or revenue cycle management.
• 1 year of similar experience with an Associate's Degree, LPN or Pharm Tech license.
• Basic level skill in Microsoft Excel (e.g., currency formatting, formulas, etc.).
• Basic level skill in Microsoft Word (e.g., formatting, spelling checks, track changes).
• Preferred qualifications include LPN, RD or Pharm Tech licensure and/or experience.
• Previous Infusion Medical Billing/Collections or Intake/Admissions Experience.

Responsibilities

• Performs Insurance Verification of benefit coverage on all of patient's insurance plans for each service provided.
• Obtains and documents in the system all information related to coinsurance, copay, deductibles, authorization requirements, etc.
• Creates documentation required to service the patient per policy and payer guidelines.
• Determines estimated patient financial responsibility using insurance verification information and payer contracts and/or self-pay guidelines.
• Obtains initial authorization prior to admitting the patient for all services for any insurance plan that has authorization requirements.
• Obtains reauthorization as necessary, reviews physician orders from pharmacy to determine if authorization is required on changes/additions to therapy for patients that are already on service.

Skills

Excel basics

Word basics

Education

High School Diploma with 2 years revenue cycle

Associate's Degree / LPN / Pharm Tech license

Job description

Job Description Summary:

Responsible for performing the appropriate procedures to verify patient eligibility, coordinate benefits, run test claims, submit initial authorization and determine patient coverage/responsibility for services and testing and implementation of new plan business. Job Description:

Job Responsibilities (listed in order of importance and/or time spent)

• Performs Insurance Verification of benefit coverage on all of patient's insurance plans for each service being provided.
• Obtains and documents in the system all information related to coinsurance, copay, deductibles, authorization requirements, etc.
• Creates documentation required to service the patient per policy and payer guidelines.
• Determines estimated patient financial responsibility using insurance verification information and payer contracts and/or self-pay guidelines.
• Obtains initial authorization prior to admitting the patient for all services for any insurance plan that has authorization requirements.
• Obtains reauthorization as necessary, reviews physician orders from pharmacy to determine if authorization is required on changes / additions to therapy for patients that are already on service.

Supervisory Responsibilities

Does this position have supervisory responsibilities? (i.e. hiring, recommending/approving promotions and pay increases, scheduling, performance reviews, discipline, etc.)

No X Yes

Basic Education and/or Experience Requirements

High School Diploma with 2 years of experience in patient registration or revenue cycle management 1 year of similar experience with an Associate's Degree, LPN or Pharm Tech license.

Basic Qualifications

Basic level skill in Microsoft Excel (for example: opening a workbook, inserting a row, selecting font style and size, formatting cells as currency, using copy, paste and save functions, aligning text, selecting cells, renaming a worksheet, inserting a column, selecting a chart style, inserting a worksheet, setting margins, selecting page orientation, using spell check and/or printing worksheets).

Basic level skill in Microsoft Word (for example: opening a document, cutting, pasting and aligning text, selecting font type and size, changing margins and column width, sorting, inserting bullets, pictures and dates, using find and replace, undo, spell check, track changes, review pane and/or print functions).

Travel Requirements: (if required)

NA

Preferred Qualifications & Interests (PQIs)

• LPN, RD or Pharm Tech licensure and/or experience
• Previous Infusion Medical Billing/Collections or Intake/Admissions Experience.

May perform other duties as assigned

Due to state pay transparency laws, the full range for the position is below:

Salary to be determined by the applicant's education, experience, knowledge, skills, and abilities, as well as internal equity and alignment with market data.

Pay Range is $21.07-$35.12

Benefits:

• Medical, Dental, & Vision Insurance
• Paid Time off
• Bonding Time Off
• 401K Retirement Savings Plan with Company Match
• HSA Company Match
• Flexible Spending Accounts
• Tuition Reimbursement
• myFlexPay
• Family Support
• Mental Health Services
• Company Paid Life Insurance
• Award/Recognition Programs

Option Care Health subscribes to a policy of equal employment opportunity, making employment available without regard to race, color, religion, national origin, citizenship status according to the Immigration Reform and Control Act of 1986, sex, sexual orientation, gender identity, age, disability, veteran status, or genetic information.