Patient Onboarding Specialist
Shields Health Solutions
Authorization and Benefits Specialist
Electromed, Inc.
full-time
Posted on:
Origin: • 🇺🇸 United States
Visit company websiteJob Level
Mid-LevelSenior
About the role
- Submitting and monitoring continuation-of-care authorizations, as well as obtaining new authorizations when insurance changes occur for existing patients ensuring uninterrupted SmartVest therapy and preventing delays in billing
- Serving as a liaison between patients, healthcare providers, and insurance companies by verifying benefits, submitting timely re-certification requests, and efficiently managing both approval and denial outcomes
- Verify insurance eligibility and DME benefits
- Comprehensively navigate payer websites
- Competently communicate with payers, clinics, PCP’s
- Effectively submit insurance requests to obtain authorization(s) and referrals
- Communicate effectively with Reimbursement Team, such as Patient Account Liaisons and Patient Services
- Educate patients on complex reimbursement situations
- Accurately record information to internal Patient Database
- Handle denied recertifications in a timely manner by obtaining needed documentation and forwarding to the Appeals Team
- Review documentation for updated patient demographics, insurance information, prescription requirements, and medical records per payer guidelines
- Complete other miscellaneous tasks as needed to help support the reimbursement team
Requirements
- High School diploma or GED required; degree preferred
- Experience working with insurance companies in the capacity of benefits, coverage, and authorizations
- Experience working directly with third party or government payers
- Experience with medical terminology
- Knowledgeable of insurance requirements and can determine medical justification to ensure proper reimbursement
- Knowledge of Microsoft Office suite
- High attention to detail and accuracy with the ability to handle multiple priorities
- Self-starter, motivated, team-player
- Excellent written and verbal communication skills
- Demonstrated exceptional customer service skills
- Ability to prioritize and organize
- Strong analytical and problem-solving skills
- Active participant of continuous improvement
