Patient Benefits Specialist (TMBP) at Cape Cod Healthcare

, , -

Full Time

Start Date

Immediate

Expiry Date

22 Dec, 25

Salary

0.0

Posted On

23 Sep, 25

Experience

0 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Insurance Verification, Patient Registration, Communication, Prior Authorization, Financial Obligations, Microsoft Office Suite, Behavioral Health, Revenue Cycle Management, Service Excellence, Demographic Verification, Charge Capture, De-escalation Certification, Hospital Procedures, Third-party Payors, CPT Procedures, DSM-V Diagnosis

Industry

Hospitals and Health Care

Description

1. Answer calls, obtains information, and ensures that the call is directed to the appropriate staff. 2. Registers patients, verifies insurance coverage, insurance deductibles, and copays. Obtains prior authorization and ensures insurance information is entered into the system. 3. Review and track patient daily census. 4. Validates insurance effective dates, coverage levels, and financial obligations of the patient in advance of scheduled service dates. 5. Communicate with patients regarding charges that may be in question including copayments and deductibles or refer them to Patient Financial Services for further questions. 6. Communicate with behavioral health staff regarding prior authorizations and verify the accuracy of demographic and payor information. 7. Maintain tracking system, notify providers when continued authorizations and certifications are required. 8. Work closely with support staff to ensure daily charge/capture reconciliation information is correct. 9. Responsible for daily work queues to resolve front end billing edits. 10. Work closely with Psychiatric Financial Manager to develop systems to improve revenue cycle management. 11. Keep current on new policies and procedures, including but not limited to, third-party payors, hospital procedures and any insurance updates. 12. Comply with departmental and organizational policies/procedures including but not limited to dress code, telephones, cell phones and computers. 13. Consistently provides service excellence to all patients, family members, visitors, volunteers and co-workers. 14. Perform other work-related duties as requested/directed by management. Ability to read, write and communicate in English. High School Diploma or GED. (BLS)- Basic Life Support certification (obtained within one (1) month of position start, offered within) Minimum of one-year experience interacting with patients. One year experience in insurance verification/authorization Payor processes in hospital and/or physician billing requirements preferred; or one year recent (within the past 3 years) comprehensive work with 3rd party billing to include DSM-V diagnosis and CPT procedures. Completion of an approved de-escalation Certification Course within 90 days from hire (offered within) Working knowledge and proficiency with Microsoft Office Suite (Word, Excel, Outlook), use of Internet. (Preferred)- Associate or Bachelor’s degree.(Preferred)- A minimum of one-year experience with hospital medical information systems such as Epic within the last three (3) years. (Preferred) – Understanding of psychiatric diagnosis and/or Mental Health Carve-Out Insurance experience.

Responsibilities

The Patient Benefits Specialist is responsible for answering calls, registering patients, verifying insurance coverage, and obtaining prior authorization. They also communicate with patients and staff regarding financial obligations and maintain tracking systems for authorizations.