Verification of Benefits Specialist
Abbott
Title : Verification of Benefits Specialist Location : Plano, TX Duration : 6+ month
Responsibilities :
Responsibilities :
- Assist with multiple levels of appeal in the event of initial coverage denial.
- Forward authorized confirmation for procedure to designated patient provider.
- In addition, this position will provide in-servicing to new patient providers surrounding the pre-authorization process.
- Responsible for managing multiple cases simultaneously within specific time frames
- Follow all policies and procedures related to performing the job role adhering to all data use, storage and privacy policies as outlined by Abbott
- Verify benefits, complete authorization requests promptly
- Timely follow up for requested authorizations
- For each procedure, audit required clinical documents for completeness and accuracy
- Obtain authorization for the facility, equipment and physician to perform various procedures from the insurance carrier
- Work with key provider contacts to obtain required clinical information for authorizations
- Work with respective carrier's utilization review department to obtain appropriate authorizations
- Work within established guidelines when necessary to process appeal for denied requests
- Train patients and their designated providers on pre-authorization processes and requirements, in person or by phone
- Work individually and in a team environment to educate assigned Field Territory Managers and Clinical Specialists
- Associate degree in Nursing/Home Health (LVN/LPN) or related field required.
- Minimum of 2 plus yrs experience in a utilization (medical approval) environment or similar work experience
- Knowledge of private insurance, Worker's Compensation and Medicare guidelines pertaining to Prospective and Retrospective Utilization Review.
- Experience in medical device or DME Billing a plus
- Proficient with Microsoft Office (Word & Excel specifically)
- Medical billing software experience a plus
- Knowledge of current CPT codes and familiarity with ICD-10CM (diagnosis coding)
- Ability to accurately meet required time frames/deadlines
- Ability to work as a team player and share workloads with other team members
- Excellent verbal and written communication skills
- Ability to train/present concepts to others.
- Medical and Prescription Drug Plans
- Dental Plan
- Vision Plan
- Health Savings Account (for High-Deductible Health Plans)
- Flexible Spending Accounts (Health, Limited Purpose, Dependent Care, Commuter Parking and Commuter Transit)
- Supplemental Life Insurance
- Short Term Disability (coverage varies by state)
- Long Term Disability
- Critical Illness, Hospital coverage, Accident Insurance
- MetLife Legal, MetLife ID Fraud, and MetLife Pet Insurance
- 401(k)
- Published on 24 Aug 2026, 9:46 PM
Vacancy posted 4 days ago
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