Patches West - Patient Benefits Coordinator at Regent Surgical

Richmond, Texas, United States -

Full Time

Start Date

Immediate

Expiry Date

26 Jan, 26

Salary

0.0

Posted On

28 Oct, 25

Experience

0 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Insurance Verification, Communication, Attention To Detail, Healthcare Insurance Plans, Billing Procedures, ICD-10 Coding, CPT Coding, HCPCS Coding, Financial Counseling, Authorization Management, Patient Interaction, Discrepancy Resolution, Record Keeping, HIPAA Compliance, Payment Collection, Reporting

Industry

Hospitals and Health Care

Description

POSITION SUMMARY: Under the direction of the Business Office Manager, the Insurance Verification Specialist ensures patients have valid and adequate insurance coverage for surgical services. They verify patient information, insurance eligibility and benefits, and authorizations and referrals before treatment including communication regarding financial responsibilities. This role requires strong communication with patients and physicians’ offices, attention to detail, and knowledge of healthcare insurance plans and billing procedures. DUTIES/RESPONSIBILITIES: Verify insurance coverage by confirming patient’s insurance eligibility and benefits with various providers (HMOs, PPOs, Medicare, and Medicaid); document and update patient insurance details in the system and maintain up-to-date records. Investigate and resolve discrepancies in insurance information attached to patient account. Ensure valid authorizations were received from physician’s office for the scheduled procedure; confirm by contacting insurance companies and contacting physician’s offices in the event of missing authorizations. Communicate coverage details, and financial estimates to patients prior to services rendered; obtain payments for procedures; address insurance-related inquiries. Collect any outstanding balances; inform revenue cycle when account has outstanding insurance balance. Document all necessary information to the billing department for accurate claims processing. Adhere to HIPAA and other relevant regulations. Understand and apply ICD-10, CPT, and HCPCS codes when verifying coverage. Remain current on all case verification; standard operating procedure is two weeks prior to date of service. Notify the Business Office Manager in the event of insurance or authorization discrepancies or balances due. Run daily reports to ensure all cases are verified, authorized, and financial counseling is complete. Perform other duties as assigned. EDUCATION/EXPERIENCE REQUIRED: High school diploma or equivalent Insurance verification or billing experience in a healthcare environment BLS certification (as required by individual ASC policy) PREFERRED Two years of insurance verification or billing experience in a healthcare environment

Responsibilities

The Patient Benefits Coordinator verifies patients' insurance coverage and ensures valid authorizations are received for surgical services. They communicate financial responsibilities and assist patients with insurance-related inquiries.