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Verification of Benefits Specialist

Spectraforce Technologies
United States, Texas, Plano
1201 West 15th Street (Show on map)
Mar 29, 2025
Title: Verification of Benefits Specialist Duration: 5 months Location: Plano, TX, 75023 Timings:8am - 5pm Duties and Responsibilities: Insurance Benefit Verification: Verify insurance benefits for patients and services. Auditing Clinical Documentation: Audit clinical documentation to identify medical treatments for specific guidelines related to the ordered procedure. Insurance Carrier Communications: Make phone calls to insurance carriers for preauthorization requests and the appeal process. Customer Service: Provide excellent customer service, including verbal and email communication, to patients and insurance carriers. Coordination of Benefits: Maintain accurate customer records in the practice management system related to benefit coverage, coordination of benefits, authorizations, denials, appeals, outcomes, and communication with insurance companies. Appeals Management: File appeals for denied coverage and follow up as necessary. Patient Financial Responsibility: Communicate and develop patient financial responsibility estimates, including collecting co-pays when applicable. Collaboration: Coordinate and communicate with other departments to obtain necessary information for benefit verification, authorizations, appeals, and outcomes. Documentation: Apply knowledge of company procedures and guidelines to process cases and respond to incoming correspondence and documentation. Update customer records based on outcomes. Experience and Skills Required: Experience: Minimum of 1-2 years of experience in insurance benefits verification and reviewing medical records. Key Skills: Strong medical terminology knowledge. Customer service skills (both verbal and written). Proficiency in data entry. Ability to work effectively as a team player. Preferred Experience: Understanding medical documentation terminology. Education and Qualifications: Required Education: High School Diploma or GED equivalent. Relevant technical field education may apply. Preferred Qualifications: Understanding of Medicare rules and regulations and managed care as it relates to benefits and authorizations. Additional Skills: Advanced proficiency in MS Office. Strong verbal and written communication skills.