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Patient Benefits Assistant

Posted on May 27, 2024
DescriptionThe Patient Benefits Specialist is responsible for administering and managing employee benefits programs, including health insurance, retirement plans, leave policies, wellness programs, and other related benefits. This role ensures that employees understand their benefits and assists them in navigating and utilizing these resources effectively.

Key Responsibilities

Insurance Verification and Authorization:

  • Verify patients' insurance coverage and benefits before appointments and procedures.
  • Obtain necessary pre-authorizations and referrals for services.
  • Communicate with insurance companies to resolve coverage issues and clarify benefits.
Patient Communication And Support
  • Explain insurance benefits, coverage options, and out-of-pocket costs to patients.
  • Assist patients in understanding their benefits and how to utilize them effectively.
  • Provide estimates for procedures and services based on insurance coverage.
Claims Assistance
  • Assist patients with filing insurance claims and resolving any issues related to denied or unpaid claims.
  • Follow up with insurance companies to ensure timely processing of claims.
  • Advocate on behalf of patients to resolve insurance-related disputes.
Financial Counseling
  • Provide financial counseling to patients regarding their healthcare costs and payment options.
  • Inform patients about available financial assistance programs and guide them through the application process.
  • Assist patients in setting up payment plans if necessary.
Compliance And Documentation
  • Maintain up-to-date knowledge of insurance policies, regulations, and procedures.
  • Ensure compliance with all federal, state, and local regulations regarding patient benefits and privacy (HIPAA).
  • Accurately document all interactions with patients, insurance companies, and healthcare providers.
RequirementsQualifications:
  • Education: Associate’s or Bachelor’s degree in healthcare administration, social work, business, or related field preferred.
  • Experience: Minimum of 2 years of experience in patient advocacy, healthcare insurance, or benefits coordination. Experience in a healthcare setting preferred.
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