RCM Insurance (Benefits) Verification Advisor

Location: 2537 Golden Bear Dr, Carrollton, TX 75006Schedule: Full timeReports to: Director of Accounts ReceivableWhat We Offer YouCompetitive payPerformance‑based bonus opportunitiesComprehensive health, dental, and vision insuranceAdditional supplemental benefits (life insurance, disability, accident, etc.)401(k) with company matchGenerous paid time off (PTO/Sick)Clear career growth and advancement opportunitiesA supportive and vibrant company cultureMany more employee perks and benefitsJob SummaryThe Benefits Verification Advisor supports the Revenue Cycle Management (RCM) department by ensuring accurate, timely, and compliant insurance verification before admission and throughout the patient stay. This high‑volume role partners closely with Admissions, Business Office, Clinical Operations, Case Management, and Managed Care teams to reduce authorization delays, minimize denials, improve reimbursement accuracy, and accelerate revenue cycle performance. The Advisor must demonstrate exceptional knowledge of Medicare, Medicaid, Managed Medicare, Commercial Insurance, Managed Care Organizations, Workers’ Compensation, Veterans benefits, and complex payer guidelines.QualificationsAssociate degree or equivalent experienceMinimum 3 years of healthcare insurance verification or patient access experienceExperience supporting Skilled Nursing Facilities (SNF), Long‑Term Care, Home Health, Hospice, or Therapy servicesStrong understanding of:– Medicare Parts A, B, C & D– Medicaid– Managed Medicare– Commercial insurance– Managed Care OrganizationsKnowledge of prior authorization processes and coordination of benefitsExperience working in high‑volume environmentsExcellent analytical, problem‑solving, and communication skillsAbility to manage multiple priorities while maintaining accuracyEssential FunctionsServe as the centralized subject matter expert (SME) for insurance eligibility, benefits verification, prior authorizations, and complex payer requirements across SNFs and ancillary service linesVerify insurance eligibility, benefits, Medicare/Medicaid coverage, managed care plans, coordination of benefits, deductibles, copays, coinsurance, spend‑downs, and patient financial responsibility prior to admission and throughout the patient stayObtain, monitor, and manage prior authorizations while ensuring compliance with payer guidelines, timelines, and documentation requirementsCollaborate with Admissions, Business Office, Clinical Operations, Case Management, Managed Care, and RCM teams to resolve insurance issues, support timely admissions, and improve reimbursement outcomesInterpret complex payer contracts, coverage limitations, and medical necessity requirements to ensure accurate financial clearanceIdentify and proactively resolve insurance discrepancies, coverage gaps, authorization issues, and payer denials by working directly with insurance carriers and internal stakeholdersMaintain accurate documentation of verification activities, payer communications, authorizations, and eligibility determinations within EMR and revenue cycle systemsMonitor payer trends, regulatory updates, and reimbursement changes; educate internal teams on evolving Medicare, Medicaid, managed care, and commercial insurance requirementsSupport revenue cycle performance by reducing preventable denials, improving first‑pass claim acceptance, accelerating authorization turnaround times, and ensuring accurate insurance verification prior to billingParticipate in continuous process improvement initiatives by developing standardized workflows, identifying operational efficiencies, and recommending best practicesEnsure compliance with CMS regulations, payer policies, HIPAA requirements, and organizational standards while maintaining exceptional customer service and confidentialityPerform other duties as assignedWe are an Equal Opportunity Employer. We offer an excellent benefit plan to include 401(k) with match, CEU reimbursement, vacation, sick time, holidays, medical, dental, and supplemental insurance plans, as well as a highly competitive compensation package.#Corp #J-18808-Ljbffr Cantex-Continuing-Care-Network