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DePelchin Children's Center
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Job Location: Houston, TX
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Requisition Number 13-0117
Post Date 9/27/2013
Title Benefit Verification Specialist
City Houston
State TX
Description
Provide professional, accurate, timely insurance verification and notification for outpatient diagnostic services. The Benefits Verification Specialist will ask appropriate questions regarding patients benefits and complete data entry and or appropriate forms to document patients benefits coverage
Responsible for the timely verification of medical insurance benefits for the service scheduled or service being provided via website and/or calling the payor (Managed Care payors, Governmental payors and Commercial payors)
Verifies insurance eligibility, benefits and preauthorization/precertification
Ensure all account activity is documented in the computer system timely and thoroughly
Validates that all necessary referrals, pre-certification and/or authorizations for scheduled service are on file and that they are valid for the scheduled test being performed
Reviews and resolves preauthorization/precertification/referral issues that are not valid and contacts insurance carriers to verify/validate requirements to ensure accuracy and avoid potential denial and contact ordering physicians office if necessary to have authorization submitted
Calculates patient estimated portions via estimation tool and enters in the computer for front desk to collect the amount. Notify Business Services Manager immediately when uninsured or underinsured patients are identified
Responsible for maintaining performance standards that ensure the department is operating at peak proficiency and that established goals are consistently being met
Work is performed under tight deadlines
Maintain effective communication with patients, physicians, medical office staff and the Health Management facilities and departments
Maintaining current knowledge and understanding of government rules, regulations.
Ability to perform all other duties as assigned or requested
Requirements
This position also requires the day to day interaction with a multidisciplinary staff and various levels of staff. It requires an above average level of flexibility, dependability, sound judgment, and creative thinking. The employee is also required to be a team player
Have the ability to handle multiple tasks simultaneously, and be flexible to meet agency needs.
Have average ability in basic mathematical functions and ten-key by touch.
Have the ability to deal with problem solving issues with limited supervision.
Must be able to process and act upon directions in a timely manner, with minimum supervision in a fast paced, high stress environment.
Must have basic knowledge of CPT, ICD-9/10 codes and benefit verification preferred
How to Apply:
Click Here to Apply
DePelchin Children's Center is an equal opportunity employer
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