Hybrid Verification of Benefits Specialist bei None

The Verification of Benefits (VOB) Specialist is responsible for accurately and efficiently verifying patient insurance benefits for a multi-state behavioral health practice. This role plays a critical part in ensuring accurate billing and minimizing financial risk by confirming active patient coverage, verifying cost-sharing details, and promptly communicating any eligibility issues. This position requires strong attention to detail, excellent communication skills, and the ability to navigate various payer portals and phone systems.

Essential Duties and Responsibilities:

· Verify patient insurance eligibility and benefits using online payer portals, phone calls to insurance companies, and other available resources.

· Accurately document patient coverage details, including plan type, effective dates, mental health and substance abuse benefits, and any limitations or exclusions, in the practice management (PM) system.

· Verify patient cost-sharing information, such as copayments, deductibles, coinsurance, and out-of-pocket maximums.

· Communicate any eligibility issues, discrepancies, or lack of coverage to the front office staff and relevant team members promptly and clearly.

· Collaborate with the billing department to resolve insurance-related issues and ensure accurate claim submissions.

· Provide excellent customer service to patients by answering inquiries regarding insurance benefits and cost-sharing responsibilities.

· Maintain up-to-date knowledge of insurance requirements and regulations across multiple states.

· Stay informed about changes in payer policies and procedures.

· Maintain accurate records of all verification activities.

· Adhere to HIPAA privacy and security regulations.

· Perform other related duties as assigned.

Qualifications:

· High school diploma or equivalent required; Associate's degree or some college preferred.

· Minimum of 2 years of experience in healthcare insurance verification, billing, or a related field.

· Experience with electronic health records (EHR) and practice management (PM) systems.

· Strong understanding of insurance terminology, benefits, and claims processing.

· Proficiency in navigating payer portals and using phone systems to verify benefits.

· Excellent communication (written and verbal) and interpersonal skills.

· Ability to work independently and as part of a team.

· Strong attention to detail and organizational skills.

· Ability to prioritize and manage multiple tasks in a fast-paced environment.

· Knowledge of HIPAA regulations.

· Experience with multi-state insurance verification is a plus.

· Experience with behavioral health billing is a plus.

Skills:

· Insurance Verification

· Benefits Investigation

· Payer Portal Navigation

· Phone Communication

· Data Entry

· Customer Service

· Problem-Solving

· Time Management

· Organization

· HIPAA Compliance

Working Conditions:

· This is a full-time position.

· The work environment is typically an office setting.

· Occasional overtime may be required.