Patient Eligibility & Benefits Specialist

OneOncology; Tennessee; On-site; USD 42,000 - 62,000; Full time

Job summary

OneOncology is seeking an Eligibility Verification and Benefit Specialist to verify new patients entering the Practice Management system and identify benefit issues early. The role supports satellite clinics, coordinates referrals, and documents coverage in the EMR. Candidates should have a HS diploma and at least 1 year in a related role preferred.

Travel to satellite clinics may be required. Strong communication, multitasking, and customer service skills are essential to ensure accurate

Qualifications

• High School diploma or equivalent.

Responsibilities

• Work and complete new patient task and perform initial verification on all new patients for assigned locations prior to appointment.
• Check daily the electronic verification system to identify any possible benefit issues for patients with same day or future appointments and communicates any concerns to the appropriate staff.
• Flag accounts on possible benefit issues by documenting accounts and notifying appropriate parties as necessary.
• Requests initial referral for appropriate patient appointments, enters documentation into Patient Management system, and notifies the Sr. Eligibility Verification and Benefit Specialist.
• Maintains knowledge of Coordination of Benefits as it relates to identifying possible claim issues prior to patient visit.
• Stays current on insurance changes utilizing all resources available (web sites, bulletins, emails, etc).
• Communicate any insurance changes to appropriate staff.
• Communicate when a patient becomes Self Pay, or obtains insurance after being Self Pay to staff.
• Documents coverage comments in EMR when reimbursement should be evaluated.
• Communicates with team supervisors regarding payer response issues or trends in the eligibility system.
• Follows policies and procedures to ensure standardization of processes.
• Notifies Eligibility Verification and Benefit Team Management of issues with potential negative outcomes for the company

Skills

Customer service

Verbal & written communication

Multi-tasking

Attention to detail

Problem solving

Teamwork

Initiative

Education

High School diploma or equivalent

Tools

MS Word

Excel

Outlook

Job description

OneOncology is seeking an Eligibility Verification and Benefit Specialist to verify new patients entering the Practice Management system and identify benefit issues early. The role supports satellite clinics, coordinates referrals, and documents coverage in the EMR. Candidates should have a HS diploma and at least 1 year in a related role preferred.

Travel to satellite clinics may be required. Strong communication, multitasking, and customer service skills are essential to ensure accurate