Benefit Verification Specialist- Remote

Company Overview

Headquartered in Atlanta, GA, EyeSouth Partners is an eye care physician services organization committed to partnering with leading physicians to build a premier network of eye care services in throughout the Southeast. EyeSouth’s partner practices’ clinical mission is to provide high quality medical and surgical specialty eye care. EyeSouth supports its affiliated practices and physician partners with capital, administrative resources, operating expertise, and strategic guidance with an absolute focus on clinical quality and a patient-first culture.

EyeSouth’s affiliate network consists of 30 practices with over 260 doctors providing medical and surgical eye care services at approximately 150 locations including 19 surgery centers throughout Georgia, Louisiana, North Carolina, Florida, Tennessee, Texas, Alabama, Ohio, Kentucky, Pennsylvania, and Illinois.

Position Summary

The Benefits Verification Specialist will contact insurance companies, on behalf of the physician’s office, to verify patient specific benefits. The Benefits Verification Specialist will ask appropriate questions regarding patient’s benefits and complete data entry and/or appropriate forms to document patient’s benefits coverage.

Retina experience preferred. 

**Applicants who live and plan to work from the following states will not be considered at this time: Alaska, Arizona, California, Colorado, Delaware, Hawaii, Idaho, Montana, Maryland, Massachusetts, Michigan, Nevada, New Mexico, Oregon, New Hampshire, New Jersey, Utah, New York, Rhode Island, Washington, and Wyoming. Thank you for your interest.

Responsibilities

• Collects and reviews all patient insurance information needed to complete the benefit verification process for multiple entities.
• Verifies patient specific benefits and precisely documents specifics for various payer plans including patient coverage, cost share, and access/provider options according to Program specific SOPs.
• Verification process could include electronic validation of pharmacy coverage and medical eligibility.
• Identifies any restrictions and details on how to expedite patient access.
• Could include documenting and initiating prior authorization process, claims appeals, etc.
• Completes quality review of work as part of finalizing product.
• Reports any reimbursement trends/delays to supervisor.
• Performs related duties and special projects as assigned.
• Ability to work in a fast-paced office environment.
• Contributes to the team effort by completing other tasks/projects as needed.

Qualifications

• Retina xperience preferred. 
• Minimum of one year of healthcare facility, provider, or payer benefits verification experience or another related field or equivalent experience required
• Prior electronic medical records experience required (EMR/EHR)
• Must possess strong ethics and a high level of personal and professional integrity
• Intermediate computer skills including Microsoft Office (preferably Word and Excel)
• Excellent interpersonal skills including the ability to interact effectively and professionally with individuals at all levels; both internal and external
• Exercises sound judgment in responding to inquiries; understands when to route inquiries to next level.
• Self-motivated with strong organizational skills and superior attention to detail
• Work requires focus, flexibility, and the ability to adapt to changing work situations.
• Team player that develops strong collaborative working relationships with internal partners and can effectively engage and ability to build consensus among cross-functional teams

Company Benefits

We offer a competitive benefits package to our employees:

• Medical
• Dental
• Vision
• 401k w/ Match
• HSA/FSA
• Telemedicine
• Generous PTO Package

We also offer the following benefits for FREE:

• Employee Discounts and Perks
• Employee Assistance Program
• Group Life/AD&D
• Short Term Disability Insurance
• Long Term Disability Insurance

EyeSouth Partners is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.