What are the responsibilities and job description for the Benefits and Eligibility and Account Specialist position at Palm Beach Orthopaedic Institute?
Description
The Orthopaedic Eligibility & Benefits and Patient Account Specialist is responsible for verifying patients’ insurance coverage, determining benefits ensuring accurate financial information prior to orthopaedic procedures or visits and collects payments from patients.
Full-time
Schedule
8:30 AM - 5 PM
Monday to Friday (No weekends!)
Work Location
On site Required: Palm Beach Gardens location
Benefits
Skills & Qualifications
The Orthopaedic Eligibility & Benefits and Patient Account Specialist is responsible for verifying patients’ insurance coverage, determining benefits ensuring accurate financial information prior to orthopaedic procedures or visits and collects payments from patients.
- Verify patient insurance eligibility and benefits (medical, surgical, therapy services)
- Confirm coverage for orthopaedic procedures (e.g., surgeries, imaging, physical therapy)
- Obtain prior authorizations and referrals when required
- Communicate patient financial responsibility (copays, deductibles, coinsurance)
- Provides telephone customer service in a high call volume environment by responding to patient billing questions as well as working payor denials and collections on patient accounts (as needed)
- Interpretation of Explanation of Benefits (EOB); responding to billing questions or requests for information; collecting patient balances
- Coordinate with insurance companies to resolve coverage issues
- Enter and update insurance information in electronic health records (EHR)
- Work closely with AR and clinical teams
- Ensure compliance with HIPAA and payer guidelines
- Document all verifications, authorizations and payments accurately
Full-time
Schedule
8:30 AM - 5 PM
Monday to Friday (No weekends!)
Work Location
On site Required: Palm Beach Gardens location
Benefits
- 401(k)
- Dental insurance
- Disability insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Skills & Qualifications
- Knowledge of medical insurance plans (PPO, HMO, Medicare, Medicaid)
- Familiarity with orthopaedic procedures and terminology (preferred)
- Knowledge of CPT, ICD-10, and HCPCS coding (basic to intermediate)
- Strong attention to detail and accuracy
- Excellent communication and customer service skills
- Experience with EHR and practice management systems
- Ability to handle high-volume verification tasks
- High school diploma or equivalent (required)
- Associate degree in healthcare administration (preferred)
- 1–3 years of insurance verification or healthcare front-end experience