Benefit Verification Specialist
Oconomowoc, WI 
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Posted 19 days ago
Job Description
The Benefit Verification Specialist is responsible for verifying patient benefit coverage with the facility, ensuring accurate data entry in the system. He/she/they reports to the manager of patient access.

Job Duties & Responsibilities:

Verify insurance benefits on patients and potential patients.

  • Place phone calls to insurance/managed care companies regarding patient benefit information and authorization requirements, as required.
  • Use online insurance/managed care portals to obtain patient benefit information and authorization requirements, as required.
  • Use facility resources and managed care grids to accurately receive, interpret and document benefit quotes provided by insurance/managed care companies.
  • Accurately document quote of benefits from insurance/managed care companies in Cerner, selecting appropriate dropdown options, assigning to follow-up worklists as needed, and entering details in necessary fields.
  • Audit demographic/insurance/financial data in Cerner, ensuring accuracy for encounters.
  • Calculate and document deposits for admissions, as applicable.
  • Communicate with admissions and utilization review teams to ensure accuracy of accounts, including requests to collect and input current policy information.
  • Knowledge of Rogers programs and the facility's admission, insurance authorization, and billing processes.
  • Provide insurance training or resources to team members, as needed.

Apply good practice principles to job duties.

  • Use good communication skills and tact to deal effectively with third-party carrier representatives, professional staff members, Hospital management, and employees.
  • Use common sense in situations and respond appropriately in all communication modes (body language, verbal) to each patient, regardless of his/her/their behavior.
  • Maintain a calm attitude and create a conducive atmosphere in difficult situations.
  • Work cooperatively and supportively with Hospital staff.
  • Remain courteous and respectful to others during work interactions and be willing to work out problems on a one-on-one basis.
  • Complete assignments and documentation on time.
  • Take responsibility for and manage day-to-day problems, including completion of all documents.

Additional Job Description:

Education/Training Requirements:

  • High school diploma required.
  • Computer skills required, including word processing.
  • Professional experience related to insurance and/or billing is strongly preferred.

 

Job Summary
Start Date
As soon as possible
Employment Term and Type
Regular, Full Time
Required Education
High School or Equivalent
Required Experience
Open
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