Resident Benefits Specialist
Dove Healthcare, Eau Claire, WI, United States
Full-time
Schedule Details Full-time
Position Summary The Resident Benefits Specialist is responsible for verifying payer sources and coordinating insurance benefits for prospective and newly admitted residents. This position plays a critical role in ensuring accurate, expeditious benefit verification, securing insurance authorizations, and supporting a smooth financial admission process for residents and families.
The Resident Benefits Specialist works closely with admissions, clinical teams, and insurance providers to validate coverage, obtain required authorizations, and ensure timely communication with residents and families regarding financial responsibilities.
Key Responsibilities Benefits Verification
Verify insurance benefits for all payer sources for new referrals and incoming admissions.
Confirm coverage eligibility, benefits, and limitations with insurance providers.
Validate private pay ability and confirm required up‑front payment arrangements when applicable.
Review and confirm secondary insurance coverage where applicable.
Medicaid & Financial Eligibility
Communicate with residents, families, and internal staff regarding Medicaid application status, requirements and documentation needs.
Insurance Authorization Management
Maintain ownership of the insurance authorization process, including:
Obtaining prior authorizations for admissions when required.
Communicate authorization status to the clinical team, admissions staff, and leadership.
Communication & Coordination
Serve as a key contact for insurance verification and authorization questions.
Communicate clearly with residents, families, referral sources, and internal team members regarding benefit coverage and financial responsibilities.
Collaborate with admissions, MDS, therapy, and billing teams to ensure accurate payer setup and coverage coordination.
Documentation & Systems
Maintain accurate documentation of benefit verifications and authorization information in facility systems.
Utilize electronic systems and payer portals to verify benefits and manage authorizations.
Ensure compliance with facility policies and payer requirements.
Qualifications Required
High school diploma or equivalent
Strong communication and customer service skills
Proficiency with computer systems and data entry
Strong organizational skills and attention to detail
Ability to manage multiple tasks and deadlines
Preferred
Knowledge of health insurance processes
Experience in long‑term care, healthcare admissions, or medical billing
Familiarity with Medicaid eligibility processes
Work Environment
This position is on‑site
Requires frequent interaction with residents, families, referral partners, and internal staff.
Key Competencies
Customer Service Orientation
Attention to Detail
Organization and Time Management
Professional Communication
Problem Solving
Health And Wellness Benefits
choose your own health insurance - our benefit design offers the flexibility to choose the plan that works best for you and your family!
company paid life and AD&D insurance
dental and vision Insurance
wellness incentives, including onsite gyms, health club reimbursement, weight loss program reimbursement
supplemental benefits, including short‑term disability, life insurance, critical illness, accident coverage, hospital indemnity, cancer
paid time off (PTO)
floating holiday
employee assistance program (EAP)
Financial Benefits
early wage access through DailyPay
childcare assistance - up to 20%
401k, with company match
financial planning resources
referral bonus - up to $700 per referral
Career Development
tuition reimbursement / scholarship opportunities
continuing education
career mapping
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or Veteran status.
About Dove Healthcare Dove Healthcare consists of 11 skilled nursing and rehabilitation centers, six assisted living residences, and three independent living complexes in Barron, Bloomer, Chippewa Falls, Eau Claire, Fennimore, Lodi, Osseo, Rice Lake, Spooner, St. Croix Falls, and Superior.
Our core services include inpatient and outpatient rehabilitation, post-hospital care, ventilator care, skilled nursing, long‑term and end‑of‑life care, as well as senior independent living, assisted living, and memory care.
As an innovative healthcare provider and community partner, we provide compassionate care and service to meet the needs of those who depend on us. We commit to excellence through adherence to high standards, disciplined leadership, and mutual respect for all.
For more information, visit dovehealthcare.com.
#J-18808-Ljbffr
Schedule Details Full-time
Position Summary The Resident Benefits Specialist is responsible for verifying payer sources and coordinating insurance benefits for prospective and newly admitted residents. This position plays a critical role in ensuring accurate, expeditious benefit verification, securing insurance authorizations, and supporting a smooth financial admission process for residents and families.
The Resident Benefits Specialist works closely with admissions, clinical teams, and insurance providers to validate coverage, obtain required authorizations, and ensure timely communication with residents and families regarding financial responsibilities.
Key Responsibilities Benefits Verification
Verify insurance benefits for all payer sources for new referrals and incoming admissions.
Confirm coverage eligibility, benefits, and limitations with insurance providers.
Validate private pay ability and confirm required up‑front payment arrangements when applicable.
Review and confirm secondary insurance coverage where applicable.
Medicaid & Financial Eligibility
Communicate with residents, families, and internal staff regarding Medicaid application status, requirements and documentation needs.
Insurance Authorization Management
Maintain ownership of the insurance authorization process, including:
Obtaining prior authorizations for admissions when required.
Communicate authorization status to the clinical team, admissions staff, and leadership.
Communication & Coordination
Serve as a key contact for insurance verification and authorization questions.
Communicate clearly with residents, families, referral sources, and internal team members regarding benefit coverage and financial responsibilities.
Collaborate with admissions, MDS, therapy, and billing teams to ensure accurate payer setup and coverage coordination.
Documentation & Systems
Maintain accurate documentation of benefit verifications and authorization information in facility systems.
Utilize electronic systems and payer portals to verify benefits and manage authorizations.
Ensure compliance with facility policies and payer requirements.
Qualifications Required
High school diploma or equivalent
Strong communication and customer service skills
Proficiency with computer systems and data entry
Strong organizational skills and attention to detail
Ability to manage multiple tasks and deadlines
Preferred
Knowledge of health insurance processes
Experience in long‑term care, healthcare admissions, or medical billing
Familiarity with Medicaid eligibility processes
Work Environment
This position is on‑site
Requires frequent interaction with residents, families, referral partners, and internal staff.
Key Competencies
Customer Service Orientation
Attention to Detail
Organization and Time Management
Professional Communication
Problem Solving
Health And Wellness Benefits
choose your own health insurance - our benefit design offers the flexibility to choose the plan that works best for you and your family!
company paid life and AD&D insurance
dental and vision Insurance
wellness incentives, including onsite gyms, health club reimbursement, weight loss program reimbursement
supplemental benefits, including short‑term disability, life insurance, critical illness, accident coverage, hospital indemnity, cancer
paid time off (PTO)
floating holiday
employee assistance program (EAP)
Financial Benefits
early wage access through DailyPay
childcare assistance - up to 20%
401k, with company match
financial planning resources
referral bonus - up to $700 per referral
Career Development
tuition reimbursement / scholarship opportunities
continuing education
career mapping
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or Veteran status.
About Dove Healthcare Dove Healthcare consists of 11 skilled nursing and rehabilitation centers, six assisted living residences, and three independent living complexes in Barron, Bloomer, Chippewa Falls, Eau Claire, Fennimore, Lodi, Osseo, Rice Lake, Spooner, St. Croix Falls, and Superior.
Our core services include inpatient and outpatient rehabilitation, post-hospital care, ventilator care, skilled nursing, long‑term and end‑of‑life care, as well as senior independent living, assisted living, and memory care.
As an innovative healthcare provider and community partner, we provide compassionate care and service to meet the needs of those who depend on us. We commit to excellence through adherence to high standards, disciplined leadership, and mutual respect for all.
For more information, visit dovehealthcare.com.
#J-18808-Ljbffr