Patient Benefits Specialist - Remote

Option Care; Nashville (TN); Remote; USD 25,000 - 42,000; Full time

Benefits offered by this job

Medical, Dental, & Vision Insurance

Paid Time off

401K Retirement Savings Plan with公司 影響

Tuition Reimbursement

Flex Spending Accounts

Job summary

Option Care Health in Nashville is hiring for an Insurance Verification specialist responsible for verifying benefits, determining patient responsibility, and coordinating initial authorizations for infusion services. You will document coverage details, manage payer requirements, and support the revenue cycle team with accurate data.

The role emphasizes attention to policy guidelines, ability to navigate payer contracts, and collaboration with clinical staff to ensure seamless service delivery.

Qualifications

• High School Diploma with 2 years of patient registration or revenue cycle experience.
• 1 year of similar experience with an Associate’s Degree, LPN or Pharm Tech license.
• Basic Excel and Word skills as described in the job posting.
• PQIs preferred: LPN, RD or Pharm Tech licensure.

Responsibilities

• Verifies insurance benefits for each service and plans coverage.
• Documents coinsurance, copays, deductibles, and authorization requirements in the system.
• Calculates estimated patient financial responsibility using contracts and guidelines.
• Obtains initial authorization before admitting patients and resequences authorization as needed.
• Reviews physician orders to determine if therapy authorization is required for changes.

Skills

Insurance verification

Revenue cycle management

Medical billing

Education

High School Diploma with 2 years exp

Associate’s Degree, LPN or Pharm Tech license

Tools

Microsoft Excel

Microsoft Word

Job description

Extraordinary Careers. Endless Possibilities.With the nation’s largest home infusion provider, there is no limit to the growth of your career. Option Care Health, Inc. is the largest independent home and alternate site infusion services provider in the United States. With over 8,000 team members including 5,000 clinicians, we work compassionately to elevate standards of care for patients with acute and chronic conditions in all 50 states. Through our clinical leadership, expertise and national scale, Option Care Health is re-imagining the infusion care experience for patients, customers and team members.Join a company that is taking action to develop an inclusive, respectful, engaging and rewarding culture for all team members. At Option Care Health your voice is heard, your work is valued, and you’re empowered to grow. Cultivating a team with a variety of talents, backgrounds and perspectives makes us stronger, innovative, and more impactful. Our organization requires extraordinary people to provide extraordinary care, so we are investing in a culture that attracts, hires and retains the best and brightest talent in healthcare.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 ResponsibilitiesDoes this position have supervisory responsibilities?(i.e. hiring, recommending/approving promotions and pay increases, scheduling, performance reviews, discipline, etc.)No XYesBasic Education and/or Experience RequirementsHigh 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 QualificationsBasic 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)NAPreferred Qualifications & Interests (PQIs)LPN, RD or Pharm Tech licensure and/or experiencePrevious Infusion Medical Billing/Collections or Intake/Admissions Experience.This job description is to be used as a guide for accomplishing Company and department objectives, and only covers the primary functions and responsibilities of the position. It is in no way to be construed as an all-encompassing list of duties.May perform other duties as assignedDue 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 $18.20-$30.32Benefits:-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 ProgramsOption 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.