Benefit Verification Specialist
Location: Bridgeville, PA
Pay: $16.00 - $17.00 /Hour
Nesco Resource is currently working with a client looking for multiple Benefits Verification Specialist to work in the Bridgeville or Moon Twp. Areas. The requirements for the position are below.
Benefit Verification Specialist:
Located in Bridgeville, PA
This role is in a call center environment and requires heavy phone contact and communication. The ability to operate standard office and computer equipment, spend most of the work day communicating via phone, and conduct data entry is required.
- High school diploma or equivalent is required.
- 2+ years of professional experience in customer service, insurance, benefits, or related area is required.
- Experienced in phone customer service is required.
- Skills in navigating a software system, documenting communication, and managing follow-up actions is required.
- Effective and empathetic communication via inbound and outbound calls is required.
- Effectively communicate with patients, physicians, third party payers, and pharmaceutical manufacturer representatives.
- Represent the company in a competent, professional and responsive manner.
- Interact with the operations and quality team consistent with team-building and professional culture established by the company.
- Coordinate the care of patient to assure access to pharmacy products and services.
- Maintain high quality customer service standards in compliance with federal and state regulations and guidelines.
- Work in collaboration with team members and management to respond to the requests.
- Verify insurance coverage for potential new patients and re-verify insurance coverage for existing patients in order to process patient prescription needs successfully.
- Demonstrate excellent customer service to patients, healthcare professionals, and insurance carriers.
- Collect the appropriate information needed to ensure insurance coverage for patient medication orders.
- Document communication in computer systems.
- Successfully process patient prescription needs, reduce exposure to adverse events, and demonstrate excellent customer service to patients, healthcare professionals, and insurance carriers.
- Contact insurance carriers to resolve insurance coverage issues.
- Interface with other departments in a collaborative effort to identify solutions which will promote customer satisfaction.
- Respond to messages and support tickets within designated timeframe.
- Maintain or exceed designate quality production standards.
- Communicate with other departments to resolve issues.
- Communicate with providers, sales agents, and account managers to problem solve.
- Recommend innovative solutions to existing issues.
- Obtain accurate demographic, insurance, and financial information from healthcare professionals and patients to complete enrollment applications for new patients.
- Communicate medical information to customers, patients, and team members via thorough understanding of products and service lines offered.
- Maintain a timely turnaround for insurance verifications.
- Perform in accordance to established company values.
- Perform other duties as assigned.
Nesco Resource is an equal employment opportunity employer and does not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age, or veteran status, or any other legally protected characteristics with respect to employment opportunities.
- Bachelor Degree in business, hospital administration, or related field is highly preferred.
- Professional experience working in healthcare environments with third party benefits verification is highly preferred.
- Knowledge/understanding of how to communicate information on health insurance, reimbursements, third party terms, and medical terminology is highly preferred.
- Knowledge of government and patient assistance programs.
- Understanding of commercial insurance concepts including drug cards and major medical benefits.
- Experience in providing timely information needed by others.
- Analytical and problem solving skills.
- Ability to work with people in a team environment while meeting individual performance goals.
- Ability to build constructive and effective relationships.
- Ability to use diplomacy and tact in resolving issues.
- Ability to diffuse high-tension situations comfortably.
- Ability to find common ground and solve problems for the good of all.
- Cooperative and able to gain trust and support.
- Ability to collaborate effectively.
- Approachable and dedicated to providing the highest quality of services.