continuumrxBirmingham, AL
Verification Specialist - Specialty
Verification Specialist - Specialty
Verification Specialist - Specialty
continuumrxBirmingham, AL
3 days ago
Medical Records SpecialistsBilling and Posting ClerksHealth Information Technologists and Medical Registrars
All Other Miscellaneous Ambulatory Health Care ServicesGeneral Medical and Surgical HospitalsOffices of Physicians
Apply for this role (opens in a new tab)The Verification Specialist - Specialty role is responsible for processing benefit verification and authorization responsibilities of specialty patient accounts.
Roles and Responsibilities:
- Verifies benefit coverage and as appropriate, financial responsibility
- Creates Insurance Benefit Summary (IBS) documents, as needed
- Identifies out-of-pocket co-pays, deductibles, and co-insurance prior to services rendered in accordance with the insuranceeligibility/coverage information provided by payor at time of insurance verification
- Obtains prior authorization for specialty therapies
- Documents all patient interaction in EMR as a billing note
- Serves as a resource and problem resolution expert for patients, Intake and SalesAs needed, verifies insurance coverage and eligibility through payor websites, E1 check, or by calling the payor directly. Documentsinformation in EMR and communicates as appropriate to team members
- Assists with Ready To Bill (RTB) as appropriate
- Performs other duties and special projects, as assigned
- Qualifications and Experience
Minimum of High School Diploma or GED.2 or more years of experience in healthcare reimbursement with a focus on insurance verification and authorizations.
Experience in coordination of benefits, including but not limited to HMO, PPO, TPA, state and federal payors; preferred but not required.
Prior work in specialty or home infusion, homecare or related field; preferred but not required
Knowledge of Specialty medications; i.e. IVIG, injections
Knowledge of Ambulatory Infusion Center verification and PA requirements
Exceptional communication - verbal and written
Exceptional interpersonal skills
Exceptional organizational and process skills
Ability to work well under pressure, meet timelines, and completes assigned projects.
Exceptional critical thinking and problem solving skills
Proven performance, history in related field
Exceptional attention to detail and demonstrated results
Exceptional track record of customer satisfaction
Also on the board Same function, level within a rung
Level
Senior
Location
Birmingham, AL
Occupation
Medical Records Specialists
Industry
All Other Miscellaneous Ambulatory Health Care Services
Posted
3 days ago