Verification of Benefits Specialist

Spectraforce Technologies, Inc.; Florida; On-site; USD 40,000 - 50,000; Full time

Job summary

Spectraforce Technologies, Inc. seeks a Verification of Benefits Specialist for 100% onsite in Lake Mary, FL. You will verify insurance benefits, initiate pre-authorizations, and coordinate with insurers to resolve coverage questions.

The role runs Monday–Friday, 8:00am to 5:00pm, on an assignment lasting 6 months. A HS diploma and prior authorization/benefits verification experience are required, with strong communication skills essential. Experience with denials and appeals is a plus.

Qualifications

• Must have prior authorization/verification experience.
• Preferred to start ASAP after screenings.
• Minimum 1 year experience in insurance benefits verification or related fields.
• Excellent verbal and written communication skills with internal and external customers.
• Ability to work under pressure and meet deadlines.

Responsibilities

• Contacts insurance companies to verify benefits and coverage.
• Initiates pre-authorization, PCP referral, and Letter of Agreement requests with follow-up.
• Files appeals for denied coverage when needed.
• Maintains patient records in the practice management system related to benefits, authorizations, denials, and outcomes.
• Coordinates with other departments to obtain necessary information for verifications and authorizations.
• Provides customers with status updates and estimates of patient financial responsibility, including co-pays if applicable.
• Applies company procedures and guidelines to process cases and update records accordingly.
• Performs other related duties as assigned.

Skills

Medicare rules

Managed care

MS Office

Communication skills

Education

HS diploma or GED

Job description

Position Title: Verification of Benefits Specialist

Work Location: 1101 Greenwood Boulevard, Lake Mary, FL, USA, 32746

Assignment Duration: 6 Months

Work Schedule: Mon - Friday 8:00am to 5:00pm

Work Arrangement: 100% onsite

Background & Context: This is not a customer service role. this is a verification of benefits role so focus on this aspect of the role.

Key Responsibilities:

• Contacts insurance companies to verify insurance benefits.
• Initiates Pre-authorization, PCP referral, and Letter of Agreement requests for new and ongoing services with insurance companies and performs follow up activities for an outcome.
• Files Appeals for denied coverage to insurance companies as needed.
• Maintains customer records in practice management system related to benefit coverage, coordination of benefits, authorizations, denials, appeals, outcomes and communication with insurance company.
• Coordinates and communicates with other departments as needed to obtain necessary information to complete benefit verification, authorization, appeals and outcomes for services of care.
• Provides customers with information that includes but is not limited to: updates on status of authorizations, developing & communicating patient financial responsibility estimates, and collecting co-pays, if applicable.
• Applies knowledge of company procedures, contracted and non-contracted guidelines to process cases accordingly and to respond to incoming correspondence and documentation as well as updating customer records according to outcomes.
• Performs other related duties as assigned.

Qualification & Experience:

• Must have prior authorization/verification experience.
• Selected Candidate will start ASAP after screenings have cleared.

Skills:

• Understanding of Medicare rules and regulations
• Understanding of managed care as it relates to benefits and authorizations
• Advanced MS Office experience
• Strong verbal and written communication skills

Minimum Requirement:

• Education: Min. HS diploma or GED equivalent
• Must have prior authorization/verification experience.
• Preferred two or more years' experience, but a minimum of 1 year experience is required in insurance benefits verification and/or collections and/or managed care contracting.
• Excellent verbal and written communication skills, including ability to effectively communicate with internal and external customers.
• Must be able to work under pressure and meet deadlines