Eligibility and Benefits Verification Specialist
Posted 2 months ago
You'll complete your application on RCM Staff LLC's career site.
About the Role
As an Eligibility and Benefits Verification Specialist, you are responsible for evaluating patient coverage status for pending medical visits. You will interact with insurance carriers and use payer platforms to verify coverage details like coinsurance, copayments, and service caps. It is your job to record behavioral health coverage information and confirm whether prior authorizations are needed. You must maintain precise and timely updates in electronic health record systems while following mandatory HIPAA privacy standards. This is a full-time, remote-based position that requires a stable internet connection and a dedicated workspace, with work hours scheduled according to Central Time.
Requirements
- You need at least one year of professional experience in U.S. healthcare insurance, specifically focusing on benefits and eligibility verification.
- You should be familiar with government and commercial health plans, such as Medicaid and Medicare.
- Your toolkit must include proficiency in insurance websites and payer portals, complemented by strong English language skills.
- You must demonstrate extreme accuracy, the ability to handle multiple files, and self-managed work habits.
- Candidates with knowledge of behavioral health services, mental health counseling, or Wisconsin-based insurance plans are preferred.
Responsibilities
- Confirm patient insurance eligibility and keep electronic health records current.
- Analyze benefit details including visit caps and copayments, and identify if prior approval is required for medical services.
- Report coverage discrepancies to the appropriate practice contact to facilitate resolution prior to patient visits.
- Complete all verification duties on schedule while upholding patient data confidentiality and HIPAA regulations.
- Manage assigned verification task lists efficiently to meet operational turnaround requirements.
Benefits & Perks
- Enjoy a fully remote employment arrangement that offers convenient work-from-home options.
- Benefit from a stable full-time position tailored for professionals residing in the Philippines.
- Join a collaborative culture that prizes your input and promotes career advancement within the healthcare recruitment industry.
Note: This listing is summarized and paraphrased by WorkNow from a publicly posted role. For the original wording and full details, please refer to the employer's official posting.
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