Reimbursement Specialist-Patient Benefits

Company: CORESTAFF Services ( Learn More )

General Information
US-NC-Cary
N/A
High School
Full-Time/Part-Time
At least 1 year(s)
Not Specified
False
False
Job Description

Reimbursement Specialist - Patient Benefits Specialist

Monday - Friday 11:00 a.m. - 8:00 p.m.

$16.00/hr pay rate; 3+ month contract position

The Patient Benefits Specialist is responsible for performing the appropriate processes to verify patient eligibility, coordinate benefits, determine patient coverage/responsibility for services and facilitate and eliminate insurance authorization barriers in accordance with company policies and procedures.

JOB DESCRIPTION

  • Confirming the accuracy of patient insurance information from the patient's profile in order to complete the insurance verification process
  • Utilize all available resources to obtain insurance coverage information for ordered services
  • Communicate with providers regarding patient updates and document in the Management Information System so that team members can quickly assess the status of the patient’s referral
  • Communicate, when applicable, with patients regarding their pharmacy benefit coverage and out of pocket responsibilities
  • Verify patient insurance coverage for specific product regimens to ensure accurate payment information is communicated and correct payment is collected from patients
  • Facilitate prior authorization with insurance companies for customer receiving same day shipments
  • Manage inbound calls on the insurance line from patients, clients, physicians, practitioners and clinics regarding inquiries about services provided, financial responsibility and insurance coverage to ensure they receive outrageous customer service
  • Scans verification of patient eligibility, benefits and out-of-pocket expenses
  • Provide team support of other Managed Care issues including but not limited to research of carrier allowable
  • Communicate and train employees regarding updates and changes regarding Managed Care Coverage
  • Coordinates with the Patient Assistance Services team to facilitate patient copay assistance and/or manufacturer assistance
  • Identify and report adverse events (AEs) and product complaints (PCs) to clinicians to eliminate team members having to place additional phone calls to patients
  • QUALIFICATIONS

  • High School Diploma or equivalent required
  • Healthcare experience preferred
  • Prefer at least 1+ years of experience working and understanding Insurance Verification/Benefits
  • Prior experience working in a Pharmacy setting preferred
  • Effective communicator
  • Excellent organizational and time management skills
  • Competent in basic computer skills
  • Multi-task oriented
  • Ability to effectively work with people
  • Conscientious and detail oriented
  • Flexible and adaptable
  • Corestaff Services is an Equal Opportunity Employer - All qualified applicants will receive consideration without regard to race, color, religion, gender, national origin, age, disability, veteran status, or any other factor determined to be unlawful under applicable law. Corestaff Services is not associated with Core Staffing Services, Inc. which operates in the New York metro area.

    Job Requirements