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- Place phone calls to insurance/managed care companies regarding patient benefit information and authorization requirements, as required.
- Use online insurance/managed care portals to obtain patient benefit information and authorization requirements, as required.
- Use facility resources and managed care grids to accurately receive, interpret and document benefit quotes provided by insurance/managed care companies.
- Accurately document quote of benefits from insurance/managed care companies in Cerner, selecting appropriate dropdown options, assigning to follow-up worklists as needed, and entering details in necessary fields.
- Audit demographic/insurance/financial data in Cerner, ensuring accuracy for encounters.
- Calculate and document deposits for admissions, as applicable.
- Communicate with admissions and utilization review teams to ensure accuracy of accounts, including requests to collect and input current policy information.
- Knowledge of Rogers programs and the facility's admission, insurance authorization, and billing processes.
- Provide insurance training or resources to team members, as needed.
- Use good communication skills and tact to deal effectively with third-party carrier representatives, professional staff members, Hospital management, and employees.
- Use common sense in situations and respond appropriately in all communication modes (body language, verbal) to each patient, regardless of his/her/their behavior.
- Maintain a calm attitude and create a conducive atmosphere in difficult situations.
- Work cooperatively and supportively with Hospital staff.
- Remain courteous and respectful to others during work interactions and be willing to work out problems on a one-on-one basis.
- Complete assignments and documentation on time.
- Take responsibility for and manage day-to-day problems, including completion of all documents.
- High school diploma required.
- Computer skills required, including word processing.
- Professional experience related to insurance and/or billing is strongly preferred.
Benefit Verification Specialist - Oconomowoc, United States - Rogers Behavioral Health
Description
The Benefit Verification Specialist is responsible for verifying patient benefit coverage with the facility, ensuring accurate data entry in the system. He/she/they reports to the manager of patient access.
Job Duties & Responsibilities:
Verify insurance benefits on patients and potential patients.
Apply good practice principles to job duties.
Additional Job Description:
Education/Training Requirements: