Verification of Benefits Specialist

Company: TalentBurst, Inc.
Location: Orlando
Posted on: May 16, 2022

Job Description:

Job DescriptionVerification of Benefits Specialist Orlando, FL 6 month initial contract Years Experience: min. 1 yr. 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; Education: min. HS diploma or GED equivalent RESPONSIBILITIES: Responsible for direct communication and building relationship contacts with health plans to secure Single Case Agreements. Responsible for the management of all Single Case Agreements, including , tracking outcomes, identifying problem payers, negotiating rates (as needed), and securing required signatures. Oversees and ensures the accuracy of Single Case Agreements meets authorization and claims requirements . Collaborate with Provider Relations Manager, Verification of Benefits Manager and Revenue Cycle manager on payment analysis and providing feedback for new patient admissions and or continuation of care. Present feedback on outcomes and correspondence or lack of correspondence related to Single Case Agreements that present risk on reimbursement outcomes. Routinely evaluates Insurance Master, Plan Guidelines and non-contracted tools of current processes and make updates as needed based on Single Case Agreement outcomes. Acquires necessary medical records and documentation from customer charts to communicate via phone, fax or e-mail with other medical facilities, hospitals and insurance carriers. Follows all regulatory policies and procedures, privacy and security standards in accordance with government agencies to include HIPAA requirements. Performs other duties as assigned by superiors BASIC QUALIFICATIONS - EDUCATION: Three to Five (3-5) years' experience in insurance benefit verification and/or collections and/or managed care contracting. Understand the process for verification of benefits and collections as it relates to the policies and procedures for effective placement of customers and reimbursement. Complete Understanding of Medicare Rules and Regulations Advanced MS Office experience, with an emphasis on MS Excel desired Continued Self Improvement courses & seminars related to position along with "In House" programs. PREFERRED QUALIFICATIONS: Knowledge in Managed Care Knowledge in Contracting and Negotiations Strong Verbal and Written Communication Skills Strong Computer/Software Skills COMPETENCIES: Problem Analysis to identify Interests and Goals Negotiating skills Decision Making Ability Active Listening skills Clear and Effective Communication Maintaining Good Relationships/Collaboration Ethics and Reliability Detail Oriented Organization/Time Management Skills

Keywords: TalentBurst, Inc., Orlando , Verification of Benefits Specialist, Other , Orlando, Florida