Verification of Benefits Specialist

The Fountain Group. We are a national staffing firm and are currently seeking a Verification of Benefits Specialist for a prominent client of ours. This position is in Plano, TX 75024Details for the position are as follows:

Verification of Benefits Specialist

Location: Plano, TX - 100% Onsite
Pay: $19-$20/hour, based on experience
Schedule: Monday-Friday, 8:00 AM-5:00 PM
Contract: 6 months with potential for extension
Start: ASAP

Position Overview

We are seeking a Verification of Benefits Specialist to support insurance verification and prior authorization activities for patients receiving medical procedures and therapies. This role will work directly with insurance carriers, healthcare providers, and internal teams to verify coverage and obtain required authorizations.

Responsibilities

• Verify patient insurance eligibility, benefits, coverage, and co-insurance.
• Use insurance carrier portals to verify benefits and authorization requirements.
• Submit and follow up on prior authorizations, pre-certifications, and pre-determinations.
• Communicate with insurance carriers and physician offices to obtain required information.
• Review clinical documentation for completeness prior to authorization submission.
• Assist with insurance appeals and denied authorization requests.
• Manage multiple patient cases while meeting required deadlines.
• Accurately document insurance and authorization information.

Qualifications

• High school diploma or equivalent required; Associate degree a plus.
• 2+ years of experience in insurance verification, prior authorization, medical billing, patient access, utilization review, or a physician office environment.
• Experience working with insurance carriers and online insurance portals .
• Strong understanding of insurance benefits, including co-pays, deductibles, and co-insurance .
• Strong computer skills; Microsoft Word and Excel experience required.
• Strong communication, organization, and attention to detail.

Preferred Experience

• Medical device or DME billing.
• Medicare, Workers' Compensation, or commercial insurance.
• CPT and ICD-10-CM codes.
• Salesforce, Adobe, or medical billing software.
• Prior authorization and insurance appeals.

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