Benefit Verification Specialist in Franklin, TN at Acadia Healthcare

Date Posted: 10/13/2021

Job Snapshot

Job Description

Overview

PURPOSE STATEMENT: 

The Benefit Verification Specialist is Responsible for the timely verification of insurance benefits and authorizations.   

ESSENTIAL FUNCTIONS: 

  • Responsible for the timely verification of insurance benefits provided via websites and/or calling the payor. 
  • Obtain precertification and authorizations for services being rendered 
  • Review and resolves prior authorization/precertification/referral issues that are not valid and contacts insurance carriers to verify/validate requirements to ensure accuracy and avoid potential denial. 
  • Validates all necessary referrals/prior authorizations/pre-certifications for scheduled services are on file and shared with all appropriate staff and are valid for the scheduled services performed. 
  • Ensure all account activity is documented in the appropriate system and shared with all appropriate staff timely and thoroughly.   
  • Identify and forward potential reimbursement problems with the Billing Team. 
  • Proactively interacts with Clinics and other appropriate staff sharing benefits, authorizations and eligibility. 

STANDARD EXPECTATIONS: 

  • Complies with organizational policies, procedures, performance improvement initiatives and maintains organizational and industry policies regarding confidentiality.  
  • Communicate clearly and effectively to person(s) receiving services and their family members, guests and other members of the health care team. 
  • Develops constructive and cooperative working relationships with others and maintains them over time. 
  • Encourages and builds mutual trust, respect and cooperation among team members. 
  • Maintains regular and predictable attendance.  

EDUCATION/EXPERIENCE/SKILL REQUIREMENTS: 

  • High school diploma or equivalent. 
  • Previous experience in patient access, registration, billing, insurance, or precertifications. 
  • Previous experience with insurance carriers preferred. 
  • Advanced computer skills including Microsoft Office; especially Word, Excel, and PowerPoint.  
  • Knowledge of office administration procedures with the ability to operate most standard office equipment. 
  • Ability to work professionally with sensitive, proprietary data & information while maintaining confidentiality. 
  • Excellent interpersonal skills including the ability to interact effectively and professionally with individuals at all levels; both internal and external. 
  • Must enjoy working in a team environment 
  • Exercises sound judgment in responding to inquiries; understands when to route inquiries to next level. 
  • Self-motivated with strong organizational skills and superior attention to detail. 
  • Must be able to manage multiple tasks/projects simultaneously within inflexible time frames.  Ability to adapt to frequent priority changes. 
  • Capable of working within established policies, procedures and practices prescribed by the organization. 
  • English sufficient to provide and receive instructions/directions.