Benefits Verification Specialist

Benefits Verification Specialist

Imprimis Group is seeking an experienced Benefits Verification Specialist for a healthcare client supporting its Hospice & Palliative Care Revenue Cycle team. This is a 100% remote, temp-to-hire opportunity for an insurance verification professional who thrives in a fast-paced environment and is interested in a long-term career opportunity.

The Benefits Verification Specialist is responsible for verifying insurance eligibility, coverage, benefits, patient financial responsibility and authorization requirements for patients receiving in-home hospice services. This is a high-volume, time-sensitive environment where timely verification is critical to helping patients receive care. The ideal candidate has strong hands-on experience with healthcare insurance verification and is comfortable working with Medicare, Medicaid and commercial insurance plans. This role requires someone who can research discrepancies, communicate directly with insurance carriers and take ownership of issues through resolution.

This is a temp-to-hire opportunity with strong long-term potential for someone looking for stability and the opportunity to join an established healthcare team.

Key Responsibilities:

• Verify insurance eligibility, coverage, benefits and patient financial responsibility.
• Review insurance information and determine appropriate next steps for verification and authorization.
• Obtain and follow up on insurance authorizations as required.
• Work with Medicare, Medicaid and commercial insurance plans.
• Contact insurance carriers directly to verify benefits and resolve eligibility or authorization issues.
• Research coverage discrepancies, coordination of benefits and primary/secondary payer information.
• Communicate with internal clinical and operational teams to obtain information needed for authorization and resolve eligibility concerns.
• Accurately document authorization and insurance information within the EMR.
• Monitor assigned electronic workflows and ensure outstanding items are followed through to resolution.
• Manage a high volume of time-sensitive requests while maintaining accuracy and attention to detail.
• Collaborate with team members and assist with changing priorities and workflows as needed.

Qualifications:

• 3+ years of healthcare insurance eligibility and/or benefits verification experience.
• High school diploma or equivalent.
• Experience working with Medicare, Medicaid and/or commercial insurance.
• Experience communicating directly with insurance companies and payer representatives.
• Prior authorization experience strongly preferred.
• Multi-state Medicaid experience is a plus.
• Hospice, home health or healthcare revenue cycle experience is a plus.
• Experience with EMR and insurance eligibility platforms.
• Strong organizational, time-management and multitasking skills.
• Excellent verbal and written communication skills.
• Strong critical-thinking and problem-solving abilities.
• Ability to work independently while contributing to a collaborative remote team.
• Comfortable working in a fast-paced environment with changing payer requirements and priorities.
• Strong interpersonal skills, organization, time management and the ability to maintain concentration in a high-volume, complex environment.

Experience with Homecare Homebase (HCHB), Waystar, Availity, Ability or similar healthcare eligibility/EMR platforms is helpful but not required. Candidates with strong insurance verification fundamentals who can quickly learn new systems are encouraged to apply.

We're looking for someone who doesn't stop at the first roadblock. The right candidate will be resourceful, responsive and comfortable asking questions, researching discrepancies and working with insurance representatives to reach a resolution. This position is especially well suited for someone who enjoys a fast-moving environment, can balance speed with accuracy, adapts well to changing processes and is looking for an opportunity to grow with a team long-term.

Interested candidates should submit their resume to View email address on click.appcast.io for consideration.