Lead Insurance Verification Specialist
cCARE cCARE Fresno, CA Fresno, CA Full-time Full-time $22 - $28 an hour $22 - $28 an hour 1 day ago 1 day ago 1 day ago Job Description The Lead 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.
Cross trains in other front end insurance verification process.
Responsibilities/Essential Functions (other duties as assigned):
The lead VOB Specialist provides clarification, training, and additional assistance to the VOB team.
Helps ensure VOB team is on pace for daily, weekly, and monthly productivity goals.
Assists with rollout of process changes to VOB team.
Cross trains in other functional areas such as Authorizations and Financial Counseling, Collects and reviews all patient insurance information needed to complete the benefit verification process.
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.
Work requires focus, flexibility, and the ability to adapt to changing work situations.
This position requires that the Associate be seated most of the day.
Education:
High school diploma or GED minimally required.
Two (2)
years directly related and progressively responsible experience and/or college degree.
Specific experience in medical office administration, benefit verification, coding, claims processing or customer service at an insurance company a plus Broader experience/training may be considered in fields such as case management, social services and pharmacy technician.
Familiarity with verification of insurance benefits a plus.
Fundamental understanding of key payers including Medicaid, Medicare and private payers Strong customer service experience Working Conditions:
This position functions primarily indoors in a medical / business environment.
Employee may be subject to blood borne pathogens, radiation, bio waste and other medically-related factors, with exposure to moderate noise levels.
Visual acuity to read and compute screen and paper documents; close and distance vision, peripheral vision depth perception, ability to adjust focus; hearing acuity to converse with staff and customers;ability to walk, stoop, bend, kneel, and lift and move 25 pounds on a regular basis; ability to sit for hours at a time.
Employee will be exposed to moderate noise levels, interruptions, and occasionally asked to work evening and weekends as needed.
Job Type:
Full-time Pay:
$22.
00 - $28.
00 per hour
Benefits:
401(k) 401(k) matching Dental insurance Disability insurance Employee assistance program Employee discount Flexible spending account Health insurance Life insurance Paid time off Tuition reimbursement Vision insurance Schedule:
Monday to Friday Ability to commute/relocate:
Fresno, CA:
Reliably commute or planning to relocate before starting work (Required)
Experience:
Insurance verification:
2 years (Required) medical billing:
1 year (Preferred) Work Location:
In person The Lead 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.
Cross trains in other front end insurance verification process.
.
Estimated Salary: $20 to $28 per hour based on qualifications.
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.
Cross trains in other front end insurance verification process.
Responsibilities/Essential Functions (other duties as assigned):
The lead VOB Specialist provides clarification, training, and additional assistance to the VOB team.
Helps ensure VOB team is on pace for daily, weekly, and monthly productivity goals.
Assists with rollout of process changes to VOB team.
Cross trains in other functional areas such as Authorizations and Financial Counseling, Collects and reviews all patient insurance information needed to complete the benefit verification process.
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.
Work requires focus, flexibility, and the ability to adapt to changing work situations.
This position requires that the Associate be seated most of the day.
Education:
High school diploma or GED minimally required.
Two (2)
years directly related and progressively responsible experience and/or college degree.
Specific experience in medical office administration, benefit verification, coding, claims processing or customer service at an insurance company a plus Broader experience/training may be considered in fields such as case management, social services and pharmacy technician.
Familiarity with verification of insurance benefits a plus.
Fundamental understanding of key payers including Medicaid, Medicare and private payers Strong customer service experience Working Conditions:
This position functions primarily indoors in a medical / business environment.
Employee may be subject to blood borne pathogens, radiation, bio waste and other medically-related factors, with exposure to moderate noise levels.
Visual acuity to read and compute screen and paper documents; close and distance vision, peripheral vision depth perception, ability to adjust focus; hearing acuity to converse with staff and customers;ability to walk, stoop, bend, kneel, and lift and move 25 pounds on a regular basis; ability to sit for hours at a time.
Employee will be exposed to moderate noise levels, interruptions, and occasionally asked to work evening and weekends as needed.
Job Type:
Full-time Pay:
$22.
00 - $28.
00 per hour
Benefits:
401(k) 401(k) matching Dental insurance Disability insurance Employee assistance program Employee discount Flexible spending account Health insurance Life insurance Paid time off Tuition reimbursement Vision insurance Schedule:
Monday to Friday Ability to commute/relocate:
Fresno, CA:
Reliably commute or planning to relocate before starting work (Required)
Experience:
Insurance verification:
2 years (Required) medical billing:
1 year (Preferred) Work Location:
In person The Lead 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.
Cross trains in other front end insurance verification process.
.
Estimated Salary: $20 to $28 per hour based on qualifications.
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