Verification Specialist - Specialty

The Verification Specialist - Specialty role is responsible for processing benefit verification and authorization responsibilities of specialty patient accounts. Roles and Responsibilities Verifies benefit coverage and as appropriate, financial responsibility Creates Insurance Benefit Summary (IBS) documents, as needed Identifies out-of-pocket co-pays, deductibles, and co-insurance prior to services rendered in accordance with the insurance eligibility/coverage information provided by payor at time of insurance verification Obtains prior authorization for specialty therapies Documents all patient interaction in EMR as a billing note Serves as a resource and problem resolution expert for patients, Intake and Sales As needed, verifies insurance coverage and eligibility through payor websites, E1 check, or by calling the payor directly. Documents information in EMR and communicates as appropriate to team members Assists with Ready To Bill (RTB) as appropriate Performs other duties and special projects, as assigned Qualifications and Experience Minimum of High School Diploma or GED. 2 or more years of experience in healthcare reimbursement with a focus on insurance verification and authorizations. Experience in coordination of benefits, including but not limited to HMO, PPO, TPA, state and federal payors; preferred but not required. Prior work in specialty or home infusion, homecare or related field; preferred but not required Knowledge of Specialty medications; i.e. IVIG, injections Knowledge of Ambulatory Infusion Center verification and PA requirements Exceptional communication - verbal and written Exceptional interpersonal skills Exceptional organizational and process skills Ability to work well under pressure, meet timelines, and completes assigned projects. Exceptional critical thinking and problem solving skills Proven performance, history in related field Exceptional attention to detail and demonstrated results Exceptional track record of customer satisfaction #J-18808-Ljbffr ContinuumRx