Benefits and Eligibility and Account Specialist
Palm Beach Orthopaedic Institute, Florida, NY, United States
Description
The Orthopaedic Eligibility & Benefits and Patient Account Specialist is responsible for verifying patients’ insurance coverage, determining benefits ensuring accurate financial information prior to orthopaedic procedures or visits and collects payments from patients.
Verify patient insurance eligibility and benefits (medical, surgical, therapy services)
Confirm coverage for orthopaedic procedures (e.g., surgeries, imaging, physical therapy)
Obtain prior authorizations and referrals when required
Communicate patient financial responsibility (copays, deductibles, coinsurance)
Provides telephone customer service in a high call volume environment by responding to patient billing questions as well as working payor denials and collections on patient accounts (as needed)
Interpretation of Explanation of Benefits (EOB); responding to billing questions or requests for information; collecting patient balances
Coordinate with insurance companies to resolve coverage issues
Enter and update insurance information in electronic health records (EHR)
Work closely with AR and clinical teams
Ensure compliance with HIPAA and payer guidelines
Document all verifications, authorizations and payments accurately
Job Type Full-time
Schedule 8:30 AM - 5 PM Monday to Friday (No weekends!)
Work Location On site Required: Palm Beach Gardens location
Benefits
401(k)
Dental insurance
Disability insurance
Health insurance
Life insurance
Paid time off
Vision insurance
Skills & Qualifications
Knowledge of medical insurance plans (PPO, HMO, Medicare, Medicaid)
Familiarity with orthopaedic procedures and terminology (preferred)
Knowledge of CPT, ICD-10, and HCPCS coding (basic to intermediate)
Strong attention to detail and accuracy
Excellent communication and customer service skills
Experience with EHR and practice management systems
Ability to handle high-volume verification tasks
Education & Experience
High school diploma or equivalent (required)
Associate degree in healthcare administration (preferred)
1–3 years of insurance verification or healthcare front-end experience
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Verify patient insurance eligibility and benefits (medical, surgical, therapy services)
Confirm coverage for orthopaedic procedures (e.g., surgeries, imaging, physical therapy)
Obtain prior authorizations and referrals when required
Communicate patient financial responsibility (copays, deductibles, coinsurance)
Provides telephone customer service in a high call volume environment by responding to patient billing questions as well as working payor denials and collections on patient accounts (as needed)
Interpretation of Explanation of Benefits (EOB); responding to billing questions or requests for information; collecting patient balances
Coordinate with insurance companies to resolve coverage issues
Enter and update insurance information in electronic health records (EHR)
Work closely with AR and clinical teams
Ensure compliance with HIPAA and payer guidelines
Document all verifications, authorizations and payments accurately
Job Type Full-time
Schedule 8:30 AM - 5 PM Monday to Friday (No weekends!)
Work Location On site Required: Palm Beach Gardens location
Benefits
401(k)
Dental insurance
Disability insurance
Health insurance
Life insurance
Paid time off
Vision insurance
Skills & Qualifications
Knowledge of medical insurance plans (PPO, HMO, Medicare, Medicaid)
Familiarity with orthopaedic procedures and terminology (preferred)
Knowledge of CPT, ICD-10, and HCPCS coding (basic to intermediate)
Strong attention to detail and accuracy
Excellent communication and customer service skills
Experience with EHR and practice management systems
Ability to handle high-volume verification tasks
Education & Experience
High school diploma or equivalent (required)
Associate degree in healthcare administration (preferred)
1–3 years of insurance verification or healthcare front-end experience
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