Benefits Verification Coordinator

Position Title: Benefits Verifications Coordinator

Reports to: Medical Billing Supervisor

Job Status: Full-Time

FLSA Status: Non-Exempt

Positions Supervised: None

Position Summary: Responsible for oversight of the insurance authorization process regarding case management and coordination of benefits, to include timely and complete processing of eligibility and benefit verification, calculating and communicating patient responsibility following set guidelines and accurate entry of related information in designated software system. Other duties as assigned.

Essential Functions:

To accomplish this job successfully, an individual must be able to perform, with or without reasonable accommodation, each essential function satisfactorily. Reasonable accommodations may be made to help enable qualified individuals with disabilities to perform the essential functions.

· Perform financial verification of insurance eligibility and benefits to determine payment responsibility

· Ensure all payer forms, notification and referrals are completed within the required timeframe

· Calculate accurate patient financial responsibility

· Document patient information in billing database according to the insurance verification guidelines to assure accurate and timely reimbursement

· Interpret payer coverage information including network participation status with provider, limited plan coverage and inactive benefits

· Perform administrative assistant/building liaison duties

· Assist staff with Insurance verification questions

Competencies:

To perform the job successfully, an individual should demonstrate the following competencies:

· Attendance/Punctuality - Is consistently at work and on time; Ensures work responsibilities are covered when absent; Arrives at meetings and appointments on time.

· Dependability - Follows instructions, responds to management direction; Keeps commitments; Commits to long hours of work when necessary to reach goals; Completes tasks on time or notifies appropriate person with an alternate plan.

· Communication - Speaks clearly and persuasively in positive or negative situations; Listens and gets clarification; Responds well to questions; Able to read and interpret written information.

· Adaptability - Adapts to changes in the work environment; Manages competing demands; Change’s approach or method to best fit the situation.

· Professionalism - Approaches others in a tactful manner; Reacts well under pressure; Treats others with respect and consideration regardless of their status or position; Follows through on commitments.

Education and Experience:

· High School Diploma or GED

· One to three years patient insurance verification experience

· One to three years working with insurance; Medicare and Medicaid.

· Preferred Education and Experience

· Two years of college and three to five years related patient insurance verification experience; previous experience working with prior authorizations; knowledge of insurance, Medicare, and Medicaid insurances; one-year administrative assistant experience; or an equivalent combination of relevant education and experience.

· Prior experience with Phreesia is a plus.

Work Environment:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually quiet.

Physical Demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The employee must occasionally lift and/or move up to 15 pounds. Specific vision abilities required by this job include Close vision and Distance vision. While performing the duties of this job, the employee is frequently required to stand; walk; sit and talk or hear.

Job Type: Full-time

Expected hours: No more than 40 per week

Benefits:

• 401(k)
• Dental insurance
• Disability insurance
• Employee assistance program
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Referral program
• Tuition reimbursement
• Vision insurance

People with a criminal record are encouraged to apply

Work Location: Hybrid remote in St. Louis, MO 63141