Job Details

divh2Job Summary/h2pThe Benefits Specialist is responsible for verifying patient insurance coverage, submitting pre-authorizations, and financial assistance support to ensure patients receive coverage for medical and infusion services provided./ppKey Responsibilities:/pulliVerify and document insurance eligibility, benefits, and coverage for all office visits and infusion services./liliObtains insurance authorization and pre-certification for office visits and infusion services./liliFacilitate insurance denial mitigation steps such as peer-to-peer reviews and appeals./liliMaintains a good working knowledge of infusion drug authorization requirements for all payers, state and federal regulatory guidelines for coverage and authorization./liliCalculate and communicate patient financial responsibility./liliProvide financial assistance support to patients including identifying patient assistance programs and manufacturer copay assistance enrollment./li/ulpQualifications:/pulliHigh school diploma or equivalent/lili2-3 years of experience in medical insurance verification and prior authorizations. Experience in infusion services is preferred./liliKnowledge of insurance terminology, plan types, structures, and approval types/liliPrevious experience with J-codes, CPT and ICD-10 coding/liliPrevious Athena use a plus, but not a requirement/liliKnowledge of medical terminology and clinical documentation review/liliStrong organizational skills/liliDetail-oriented/liliAbility to multi-task and work well in a fast-paced setting/liliCritical thinking skills and decisive judgment/li/ul/div