Patient Benefits Specialist

1:32 PM

Kelly Services is looking for an experienced Patient Benefits Specialist for the Coppell, TX area, who works well independently, have worked in the medical field and also supports their co-workers in running a successful revenue cycle and patient benefits department.

Job Duties:

• Communicates with various regional and national payers, including Federal, State, Third Party

(HMO,PPO, IPA, TPA Indemnity) to validate health plan eligibility, benefits, deductibles and maintains accurate documentation.

• Serves as the point of contact for patients to ensure accurate communication of health plan benefits and eligibility and answers all patient concerns regarding coverage and billing details.
• Coordinates all patient and insurance billing for the medical laboratory; ensures that patient information is entered accurately, verify patient insurance eligibility and benefits, submit prior authorizations and submit clean claims to insurance companies on a daily basis.
• Reviews physician referrals for completeness and accuracy ensuring the referral includes patient information, diagnosis code, type of service, physician signature, date and authorization number is required.
• Fax referral to referring physician if information is incomplete.
• Establishes payment plans to help patients manage their payments, provide customer service to patients.
• Prepares, reviews, and transmits claims using billing software, including electronic and paper claim processing.
• Confirms patient demographic, insurance and referring physician information is accurately entered into system.
• Identifies and bills secondary or tertiary insurances.
• Provides case progress, insurance inquiry and reimbursement report to management.
• Maintains contact with patients and medical facilities and provides updates on authorization progress and case processing status.
• Maintains patient confidentiality as per the Health Insurance Portability and Accountability Act of1996 (HIPPA).
• Performs other related duties or special projects as assigned.

Requirements:

• High School Diploma; Associate’s/Bachelor’s degree or equivalent experience preferred.
• Medical Certification is highly desirable (Coding and Billing Cert.)
• 1-3 years of Customer Service experience in the health industry.
• 1-3 years of work experience in Medical Billing and Coding.
• 1-3 years of work experience in high call volume setting with insurance and patients.
• Knowledge of and experience with CPT-4 and ICD-9 and HCPC billing, coding and posting charges in medical billing software.
• Knowledge of insurance guidelines including HMO/PPO, Medicare, Medicaid, and other payer

requirements and systems.

• Knowledge of insurance plan benefits and terminology.
• Knowledge of and experience with contract payer policies and procedures.
• Knowledge of HIPPA compliance.
• Proficient in Microsoft Office Suite applications High School Diploma; Associate’s/Bachelor’s degree or equivalent experience preferred.
• Knowledge of and experience with contract payer policies and procedures.
• Knowledge of HIPPA compliance.
• Proficient in Microsoft Office Suite applications. Must be accurate with attention to detail.
• Customer service skills for interacting with medical billing clients and patients regarding medical claims and payments.
• Ability to work well in a team environment. Being able to triage priorities, delegate tasks if needed, and handle conflict in a reasonable fashion

Location: Coppell, TX

Monday - Friday, 9:00 AM - 5:30 PM and 10:30 AM - 7:00 PM

Fully Onsite

6mo. Contract/Possible Temp-to-hire