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Robert Half Verification of Benefits Specialist in Plano, Texas



Contacts insurance companies to verify insurance benefits

initiates pre-authorization requests for new and ongoing services with insurance companies and performs follow up activities for an outcome

files Appeals for denied coverage to insurance companies as needed

maintains customer records in practice management system related to benefit coverage, coordination of benefits, authorizations, denials, appeals, outcomes and communication with insurance company

coordinates and communicates with other departments as needed to obtain necessary information to complete benefit verification, authorization, appeals and outcomes for services of care

provides customers with information that includes but is not limited to: updates on status of authorizations, developing & communicating patient financial responsibility estimates, and collecting co-pays, if applicable

applies knowledge of company procedures, contracted and non-contracted guidelines to process cases accordingly and to respond to incoming correspondence and documentation as well as updating customer records according to outcomes; performs other related duties as assigned


Years Experience: min. 1 yr.

Skills: understanding of Medicare rules and regulations understanding of managed care as it relates to benefits and authorizations advanced MS Office experience strong verbal and written communication skills

Education: min. HS diploma or GED equivalent

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