Company Overview

At Community Eye Care Specialists our mission is to provide our patients with the highest level of quality care and we treat them like members of our family -- because they are. We serve the Northern PA and the Southern NY area with office locations in Warren, Dunkirk, Olean, Seneca, and Jamestown. Our mission is simple as we are helping people see!

Position Summary

The Benefits Verification Specialist will contact insurance companies, on behalf of the physician’s office, to verify patient specific benefits. The Benefits Verification Specialist will ask appropriate questions regarding patient’s benefits and complete data entry and/or appropriate forms to document patient’s benefits coverage.

Responsibilities

• Collects and reviews all patient insurance information needed to complete the benefit verification process for multiple entities.
• Verifies patient specific benefits and precisely documents specifics for various payer plans including patient coverage, cost share, and access/provider options according to Program specific SOPs.
• Verification process could include electronic validation of pharmacy coverage and medical eligibility.
• Identifies any restrictions and details on how to expedite patient access.
• Could include documenting and initiating prior authorization process, claims appeals, etc.
• Completes quality review of work as part of finalizing product.
• Reports any reimbursement trends/delays to supervisor.
• Performs related duties and special projects as assigned.
• Ability to work in a fast-paced office environment.
• Contributes to the team effort by completing other tasks/projects as needed.

Qualifications

• Minimum of one year of healthcare facility, provider, or payer benefits verification experience or another related field or equivalent experience required
• Prior electronic medical records experience required (EMR/EHR)
• Must possess strong ethics and a high level of personal and professional integrity
• Intermediate computer skills including Microsoft Office (preferably Word and Excel)
• Excellent interpersonal skills including the ability to interact effectively and professionally with individuals at all levels; both internal and external
• Exercises sound judgment in responding to inquiries; understands when to route inquiries to next level.
• Self-motivated with strong organizational skills and superior attention to detail
• Work requires focus, flexibility, and the ability to adapt to changing work situations.
• Team player that develops strong collaborative working relationships with internal partners and can effectively engage and ability to build consensus among cross-functional teams

Company Benefits

We offer a competitive benefits package to our employees:

• Medical
• Dental
• Vision
• 401k w/ Match
• HSA/FSA
• Telemedicine
• Generous PTO Package

We also offer the following benefits for FREE:

• Employee Discounts and Perks
• Employee Assistance Program
• Group Life/AD&D
• Short Term Disability Insurance
• Long Term Disability Insurance

EyeSouth Partners is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.