Benefit Verification Specialist/Pt Enrollment , AS+

Role Summary

Benefit Verification Specialist/ Pt Enrollment, AS+

Responsibilities

• Taking calls and outreach from health care professionals (HCPs) and entering data into supporting systems to initiate enrollment of new and existing patients
• Initiating benefits verification by reviewing patient data and insurance material, including identifying missing information and following up with points of contact to resolve information gaps
• Verifying benefits for each assigned patient case and detailing any requirements for reimbursement including copays, coinsurance, utilization management requirements, qualifications / restrictions, and prior authorization requirements
• As applicable, initiating subsequent actions (e.g. prior authorizations, appeals, travel and appointments)
• Monitoring potential delays or pended cases, and identifying and documenting lessons learned and potential leading practices resulting in shorter processing times or higher success rates
• As required, supporting new initiatives and process improvement activities (e.g. end user testing of new system features and supporting technology)
• Understanding, and adhering to, government regulations and company policies
• Maintains positive rapport with internal and external customers through effective communication and active listening
• Able to remain agile with multiple plan designs and call types

Qualifications

• Basic Qualifications:
  • High school diploma or GED
  • At least two (2) years of related experience (healthcare related administration, medical coding and billing, customer service, direct benefits verification support, etc.)
• Preferred Qualifications:
  • Bachelor‚Äôs degree in a related field of study
  • Current AS+ HUB experience

Skills

• Delivering a high quality, accurate compassionate customer experience
• Using innovative technology while maintaining the integrity of quality information across processes and activities
• Strong problem-solving skills and experience with finding resolution to complex problems
• Learning through formal and informal channels, including through a spirit of continuous personal improvement, innovation, and dedication to the successful outcomes for patients
• Communicating optimally through both written and verbal and adapt style depending on the person or audience

Education

• None specified

Additional Requirements

• None specified