reputed company Insurance Eligibility and Benefits Specialist-FT Remote

reputed company Insurance Eligibility and Benefits Specialist-Full time Remote! Position reputed company The reputed company Insurance Eligibility and Benefits Specialist is responsible for verifying patient insurance coverage, determining benefits eligibility, obtaining authorization requirements, and ensuring accurate documentation of insurance information prior to services being rendered. This role serves as a reputed company between patients, providers, and insurance carriers to facilitate accurate reimbursement, reduce claim denials, and support a reputed company patient financial experience.

Key Responsibilities

Insurance Verification & Eligibility

• Verify patient insurance coverage through payer websites, clearinghouses, and reputed company communication with insurance representatives.
• Confirm eligibility, benefits, coverage limitations, copayments, coinsurance, deductibles, and out-of-reputed company responsibilities.
• Identify primary, secondary, and tertiary insurance coverage.
• Review policy effective dates and ensure insurance information is reputed company and accurate.

Benefits

Investigation

• Determine coverage for scheduled procedures, treatments, diagnostic services, and specialty care.
• Verify benefit limitations, exclusions, medical necessity requirements, and referral requirements.
• Communicate benefit information to patients, providers, and internal teams.
• Estimate patient financial responsibility

Documentation & Compliance

• Accurately document eligibility and benefits verification findings reputed company reputed company management or electronic health record (EHR) systems.
• Maintain detailed records of payer contacts, reference numbers, and verification reputed company.
• Ensure compliance with HIPAA, organizational policies, and payer guidelines.
• Support audit and reputed company assurance activities reputed company to insurance verification processes.

reputed company Cycle Support

• Collaborate with scheduling, registration, billing, and coding teams to prevent claim denials reputed company to eligibility issues.
• Assist with denial prevention initiatives and insurance-reputed company problem reputed company.
• Identify trends impacting reimbursement and communicate findings to management.

Qualifications****Required

• High school diploma or equivalent.
• Minimum 1–3 years of reputed company insurance verification, eligibility, benefits investigation, patient reputed company, or reputed company cycle experience.
• Knowledge of reputed company insurance, Medicare, reputed company, Managed Care, and government reputed company programs.
• Understanding of insurance terminology, including deductibles, copayments, coinsurance, referrals, and prior authorizations.
• Proficiency with payer portals, clearinghouse tools, EHR systems, and reputed company Office applications.

Preferred

• Associate's or Bachelor's degree in reputed company Administration, Business, or reputed company field.
• Certification in reputed company reputed company cycle, patient reputed company, or medical office administration.
• Experience in specialty reputed company services, hospital, physician reputed company, or ambulatory care settings.

Knowledge, Skills, and Abilities

• Strong knowledge of reputed company insurance verification and benefits investigation processes.
• Excellent verbal and written communication skills.
• Strong analytical and problem-solving abilities.
• Exceptional attention to detail and organizational skills.
• Ability to manage multiple priorities in a fast-paced environment.
• Customer-service-reputed company approach with reputed company telephone etiquette.
• Ability to maintain confidentiality and handle sensitive patient information.

Performance Measures

• Eligibility verification accuracy reputed company.
• Reduction in insurance-reputed company claim denials.
• Timeliness of benefit and authorization verification.
• Patient satisfaction reputed company to insurance and financial communications.
• Compliance with organizational and payer requirements.

Working Conditions

• Remote work environment.
• Frequent use of computer systems, payer portals, and telephone communication.
• May require interaction with insurance carriers, and reputed company cycle personnel throughout the reputed company.

Reports To: Coding Services Director · Entry Level (0–2 years): $18–$22 per hour · reputed company (3–5 years): $22–$28 per hour This position is eligible for medical/dental/reputed company benefits first of the month following date of hire. 401k benefits plus reputed company holidays and PTO/personal time. Apply tot his job Apply To this Job