Patient Benefits Specialist

1:32 PMKelly Services is looking for an experienced Patient Benefits Specialist for the Coppell, TX area, who works well independently, have worked in the medical field and also supports their co-workers in running a successful revenue cycle and patient benefits department.Job Duties:Communicates with various regional and national payers, including Federal, State, Third Party(HMO,PPO, IPA, TPA Indemnity) to validate health plan eligibility, benefits, deductibles and maintains accurate documentation.Serves as the point of contact for patients to ensure accurate communication of health plan benefits and eligibility and answers all patient concerns regarding coverage and billing details.Coordinates all patient and insurance billing for the medical laboratory; ensures that patient information is entered accurately, verify patient insurance eligibility and benefits, submit prior authorizations and submit clean claims to insurance companies on a daily basis.Reviews physician referrals for completeness and accuracy ensuring the referral includes patient information, diagnosis code, type of service, physician signature, date and authorization number is required.Fax referral to referring physician if information is incomplete.Establishes payment plans to help patients manage their payments, provide customer service to patients.Prepares, reviews, and transmits claims using billing software, including electronic and paper claim processing.Confirms patient demographic, insurance and referring physician information is accurately entered into system.Identifies and bills secondary or tertiary insurances.Provides case progress, insurance inquiry and reimbursement report to management.Maintains contact with patients and medical facilities and provides updates on authorization progress and case processing status.Maintains patient confidentiality as per the Health Insurance Portability and Accountability Act of1996 (HIPPA).Performs other related duties or special projects as assigned.Requirements:High School Diploma; Associate's/Bachelor's degree or equivalent experience preferred.Medical Certification is highly desirable (Coding and Billing Cert.)1-3 years of Customer Service experience in the health industry.1-3 years of work experience in Medical Billing and Coding.1-3 years of work experience in high call volume setting with insurance and patients.Knowledge of and experience with CPT-4 and ICD-9 and HCPC billing, coding and posting charges in medical billing software.Knowledge of insurance guidelines including HMO/PPO, Medicare, Medicaid, and other payerrequirements and systems.Knowledge of insurance plan benefits and terminology.Knowledge of and experience with contract payer policies and procedures.Knowledge of HIPPA compliance.Proficient in Microsoft Office Suite applications High School Diploma; Associate's/Bachelor's degree or equivalent experience preferred.Knowledge of and experience with contract payer policies and procedures.Knowledge of HIPPA compliance.Proficient in Microsoft Office Suite applications. Must be accurate with attention to detail.Customer service skills for interacting with medical billing clients and patients regarding medical claims and payments.Ability to work well in a team environment. Being able to triage priorities, delegate tasks if needed, and handle conflict in a reasonable fashionLocation: Coppell, TXMonday - Friday, 9:00 AM - 5:30 PM and 10:30 AM - 7:00 PM Fully Onsite6mo. Contract/Possible Temp-to-hire

Created: 2025-02-02