Pre-Authorization & Benefits Verification Specialist

Socket.dev; United States; On-site; USD 38,000 - 54,000; Full time

Job summary

Confluent Health, LLC is seeking a Financial Clearance Specialist to ensure benefits verification and authorizations are obtained before services are rendered, while maintaining patient experience protocols.

You will reverify benefits, enter accurate demographics and insurance data in the EMR, monitor authorizations and eligibility to prevent revenue loss, and stay informed on Medicare, Medicaid, HIPAA rules.

Qualifications

• High school diploma required.
• 1-2 years of financial clearance experience preferred but not required.
• Proficient with Excel, PowerPoint and Word.

Responsibilities

• Verifies insurance benefits for all new patients prior to the Initial Evaluation.
• Reverifies benefits as needed due to insurance changes/updates.
• Ensures patient demographics and insurance benefits are entered accurately in the EMR.
• Obtains authorizations for services when required by the insurance plan.
• Ensure authorization details are entered accurately into the EMR.
• Monitors authorizations, visit counts, eligibility status to ensure no loss of revenue due to expired authorizations, exceeded visit counts or ineligibility.

Skills

Data-driven

Fast-paced

Customer service

Analytical thinking

Education

High school diploma

Tools

Excel

PowerPoint

Word

Job description

Confluent Health, LLC is seeking a Financial Clearance Specialist to ensure benefits verification and authorizations are obtained before services are rendered, while maintaining patient experience protocols.

You will reverify benefits, enter accurate demographics and insurance data in the EMR, monitor authorizations and eligibility to prevent revenue loss, and stay informed on Medicare, Medicaid, HIPAA rules.