Client Benefit Specialist

Job Details

Employment Type
Direct Hire
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Seeking a Client Benefit Specialist for a large non-profit organization. This individual is responsible for the verification and coordination of client benefits as part of the registration and admission process for the clinics. The Client Benefit Specialist will work closely with the outpatient clinic staff, care coordination, and billing staff to verify, document, and communicate insurance eligibility, and manage eligibility for ongoing service delivery.

Responsibilities:

  • Performs comprehensive verification of client mental/behavioral health benefits included but not limited to Medicaid and commercial insurance. Specific information to include network status, benefits, deductible, co-insurance, co-pay, and any limitations.
  • Accurately and per organizational procedure documents and communicates benefits prior to initiation of services.
  • Coordinates with the Billing Staff to resolve precertification and insurance verification concerns or questions. Assures that denied or limited benefits are communicated promptly to clinic staff.
  • Monitors and updates benefit assignments for clients in the organization's electronic record and communicates updates to program staff, including but not limited to; the clinical team and Billing.
  • Maintains timely and accurate documentation in the organization's electronic record of updates in regards to insurance coverage and benefit assignments.
  • Attends and participates in team meetings and in-service trainings as needed/required.
  • Performs other responsibilities and duties as requested and/or assigned by the Revenue Cycle Manager and Leadership.
  • Meets all Key Performance Indicators (KPIs).


Requirements:

  • Minimum of 1-year experience in healthcare provider business office performing insurance verifications for commercial and government payers.
  • Associates Degree or Technical College degree in healthcare-related field preferred.
  • Must be proficient in computer software skills such as Microsoft Excel and Word.
  • Excellent verbal and written communication skills are also required.

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