Demo

Remote Benefit Verification Specialist - Weekend

Shared Services Center - Fort Smith
Fort Smith, AR Remote Full Time
POSTED ON 1/30/2025
AVAILABLE BEFORE 3/29/2025

Job Summary

The primary function of this position is to verify insurance for payment of procedures.

Essential Functions

  • Interact with physician offices and patients in a timely courteous manner
  • Verifies insurance benefits, eligibility, and pre-determination requirements for all scheduled patients
  • Verify correct insurance package has been loaded into the patient's chart
  • Review provider schedule in electronic medical record and obtain referrals for HMO patients; authorizations for procedures and radiology testing
  • Review provider schedules in Hospital Radiology to look for and obtain authorizations for procedures and radiology testing
  • Review the Authorization/Referral list in Athena and obtain/attach proper Authorizations and Referrals for pending appointments
  • Utilize patient financial system and other computer systems to create the authorizations/referrals and attach to all relevant appointments
  • Track and monitor authorizations/referrals to account for benchmark data
  • Coordinates with the physician’s office when a required pre-determination has not been obtained
  • Contacts patient in advance, notifies of estimated liability and payment options
  • Utilize patient financial system and other computer systems to access and update surgery schedules, patient information for registration and up-front patient responsibility
  • Answers telephone, questions, and returns calls in a courteous timely manner
  • Assists and backs up other business office positions as needed
  • Performs other duties as assigned.
  • Complies with all policies and standards.

Qualifications

  • H.S. Diploma or GED preferred
  • 1-2 years customer service required
  • 1-2 years health care / medical office experience preferred

Knowledge, Skills and Abilities

  • To perform this job successfully, an individual should be proficient at working with computers and Google Suite. Experience working with patient financial systems, specifically patient financial systems (e.g., Athena, Availity, Tricare, ) preferred.
  • A good understanding of medical terminology required

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