Verification of Benefits Specialist - FT Temporary

Company: Wellbridge Addiction Treatment and Research
Location: Calverton
Posted on: May 28, 2023

Job Description:

Position SummaryThe Verification of Benefits Specialist (VOB) is an integral role within the Revenue Cycle. The VOB Specialist researches, analyzes, and evaluates payer status and determines insurance coverage specifically for substance abuse and mental health benefits. The position will work closely with Call Center team members, Admissions, Financial Advocates, Managed Care, Contracting, and Patient Accounts team members. The Verification of Benefits Specialist will work in multiple systems, Sales Force Service Cloud, Aura and online payer portals. In-depth insurance knowledge and detailed documentation is required. The Verification of Benefits Specialist is responsible to research, analyze, and evaluate network status, eligibility, authorization requirements, deductibles, coinsurance, out of pocket maximums, copays, exclusions, limitations, and any other requirements of the plan. The Verification of Benefits Specialist is responsible for clearly and precisely documenting all relevant information in the EHR to be relayed to the patient and verifying that all data is accurate and updated for efficient claim processing.ResponsibilitiesUse multiple systems to manage workflows and queues efficiently.Research, analyze, and evaluate new patient insurance information, including network status, effective dates, deductibles, coinsurance, copays, maximum out of pockets, authorization requirements, claims address, electronic payer ID, exclusions, limitations, and any other requirements of the plan for all applicable levels of care. Document all relevant information in the EHR for other departments and communication purposes to patients and families.Ensure the correct health plan is selected upon completion of verification. The accuracy and integrity will impact the workflow of each department involved in the revenue cycle process and will allow for maximum reimbursement to be completed efficiently.Effectively communicate with all interested parties regarding patient insurance benefit information, referrals, requirements, and any other pertinent information needed to accurately and efficiently complete their workflows.Prioritize queues, emails, and other tasks efficiently and timely to meet deadlines while providing exceptional customer service to our patients and other stakeholders. Identify and prioritize urgent cases to assist others.Maintain thorough knowledge of insurance, contracts, and authorization processes.Use insurance portals and other on-line tools for expedient and accurate retrieval of insurance benefits. Identify incomplete or questionable information that will require further follow-up with insurance via a phone call.Enter clear, accurate, detailed, and timely documentation in all applicable systems.Perform audits of all new patient encounters to ensure that insurance information entered and updated is accurate.Verify that the review agency and phone number is clearly documented.Review that the correct health plan is selected to avoid any disruptions to the workflow of other departments and to confirm that claims are routed to the appropriate payer to ensure efficient and timely processing.Use customer service skill with patients, family members, insurance companies, and managed care companies.Keep medical records according to standard of practice.Use computer systems to facilitate flow of patient information.Sign medical records in a timely manner.Acquire skill as technological advancements are made, i.e., computer skills, phone mail, e-mail, etc.Responsible for maintaining a system for initial and subsequent verification of benefits.Responsible for daily reporting of verification of benefit activities.Perform other duties as assigned.Required Experience and QualificationsHigh school diploma or GED.Knowledge of behavioral health/substance use disorder benefits.Utilization review knowledge working with insurance companies, helpful.Experience with addiction and levels of care, preferred.Exemplary customer service skills.Attention to detail and ability to complete the job with minimal errors.Excellent oral and written communication skillsAbility to prioritize and manage time effectively.Ability to maintain confidentiality.Proficient with Microsoft Suite: Word, Excel, PowerPoint, and Outlook.

Keywords: Wellbridge Addiction Treatment and Research, New Haven , Verification of Benefits Specialist - FT Temporary, Other , Calverton, Connecticut