Benefits Specialist

divh2Insurance Verification Specialist/h2pPremier Medical Resources is looking for an Insurance Verification Specialist to join our team. Remote opportunity after 30-90 day in-person training. The Insurance Verification Specialist is responsible for verifying the patients insurance coverage ensuring surgery and procedures are covered by an individuals insurance plan. Creates cost estimates prior to the surgery date and communicates cost to patients. In addition to entering and verifying accurate data and updating patient benefit information in the Electronic Medical Records (EMR)./ppEssential Functions:/pulliAssists front office with verification questions or concerns/liliResolves any coverage issues and update patient EMR/liliEnters insurance coverage (co-payments, deductibles, etc.) accurately into patient EMR/liliServes as a liaison between the patient, facility, physicians, and other departments to ensure timely and accurate financial clearance of all accounts/liliVerifies patient insurance coverage and benefits through online portals, phone calls, and other resources/liliVerifies insurance eligibility along with benefits and ensures all notifications and authorizations are completed by the surgery date/liliIdentifies patient accounts based on self-pay, PPO, HMO, personal injury, workmens compensation, or other managed care organizations/liliCollects relevant data for eligibility and benefit verification including all ICD-10 and billable CPT codes per orders/liliCommunicates with internal and external individuals to obtain information, resolve benefit issues, and ensure accurate benefit information is obtained/liliResponds to inquiries regarding patient accounts with appropriate and accurate information in a professional manner/liliEnsures accounts are financially secured by reviewing and documenting benefits, patient responsibilities, authorization requirements, and other relevant information/liliCreates financial arrangements alongside management when a patient is unable to complete payment/liliResponds promptly to requests and keeps open channels of communication with physician, patient, and service areas regarding financial clearance status and resolution/liliCollaborates with billing and coding departments to ensure correct processing of claims/liliCalculates co-pay and estimated co-insurance due from patients per the individual payer contract and plan as applicable/liliCompletes high-quality work while adhering to productivity standards/liliPerforms miscellaneous job-related duties as assigned/li/ulpKnowledge, Skills, and Abilities:/pulliDemonstrates ability to use basic computer functions, technology, and Microsoft office (excel, word)/liliBroad knowledge of the content intent and application of HIPAA, federal, and state regulations/liliAbility to work independently with little or no supervision as well as function within a team/liliKnowledge with in and out of network insurances, insurance verification, patient responsibility, and process for prior authorization/liliGood communication skills (verbal/written) providing a great patient experience/liliAbility to work effectively in a fast-paced environment/liliStrong knowledge of managed care, medical terminology, CPT Coding, and ICD10/liliDemonstrates use of appropriate modifiers, HIPAA regulations, and insurance verification procedures/liliKnowledge of payor guidelines including reading, understanding, and interpreting medical records and payor requirements, etc./liliAbility to think critically, assess problems, and provide problem resolutions/liliDemonstrates attention to detail, accountability, people skills, problem solving, and decision-making skills/li/ulpEducation and Experience:/pulliHigh School Diploma or GED/liliOne (1) year of revenue cycle experience/liliOne (1) year of experience with insurance verification in a hospital/ASC setting/li/ulpBenefits:/pulli3 Medical Plans/lili2 Dental Plans/lili2 Vision Plans/liliEmployee Assistant Program/liliShort- and Long-Term Disability Insurance/liliAccidental Death

Dismemberment Plan/lili401(k) with a 2-year vesting/liliPTO + Holidays/li/ulpPremier Medical Resources is a healthcare management company headquartered in Northwest Houston, Texas. At Premier Medical Resources, our goal is to leverage and combine the expertise and skillset of our employees to drive quality in all we do. Our goal is to create career pathways for our employees just starting their professional career and to those who seek to bring their expertise and leadership as we strive to combine best practices and industry excellence. Come join our team at Premier Medical Resources where passion and career meet./ppCompensation to be determined by the education, experience, knowledge, skills, and abilities of the applicant, internal equity, and alignment with market data. Employment for this position is contingent upon the successful completion of a background check and drug screening./ppPlease visit our website for more information: www.pmr-healthcare.com/p/div