Job Openings Eligibility & Benefits Verification Representative

About the job Eligibility & Benefits Verification Representative

Job Summary:

We are seeking a highly detail-oriented Eligibility & Benefits Verification Representative to join our fast-paced Neurology practice. The ideal candidate will be responsible for verifying patient insurance eligibility, benefits, and copay information; maintaining accurate patient records; and ensuring all documentation within the Electronic Health Record (EHR) system is complete and up to date.

This role plays a critical part in ensuring smooth patient access to care by validating insurance coverage, managing referrals, and supporting accurate patient chart maintenance.

Key Responsibilities:

          Insurance Verification
          • Verify patient insurance eligibility, benefits, coverage details, and copay responsibilities.
          • Ensure all insurance information is accurately documented in the EHR system.
          • Confirm referral effective and termination dates as needed.
          Patient Chart Management
          • Update and maintain patient charts with accurate insurance and referral information.
          • Flag patient accounts and charts when necessary to ensure proper follow-up.
          • Enter copay amounts to be collected at the time of service.
          Referral and Documentation Management
          • Review, attach, and manage referrals within patient records.
          • Ensure all supporting documentation is complete and accurately entered.
          • Maintain compliance with documentation standards and office policies.
          Patient Profile Administration
          • Create new patient profiles when required.
          • Identify, merge, and correct duplicate patient records.
          • Maintain the integrity and accuracy of patient demographic and insurance information.
          Quality and Compliance
          • Safeguard confidential patient information in accordance with HIPAA and company policies.
          • Perform data verification and quality checks to ensure record accuracy.
          • Support a positive patient experience through excellent customer service and professionalism.

        Qualifications:

          Required
          • College graduate from a medical-related course or healthcare-related field.
          • Previous experience in Eligibility and Benefits Verification within a healthcare setting.
          • Working knowledge of insurance verification processes, benefits investigation, and referral management.
          • Experience using Electronic Health Record (EHR) systems.
          • Strong attention to detail and organizational skills.
          • Excellent verbal and written communication skills.
          • Ability to maintain confidentiality and handle sensitive patient information.
          • Strong customer service skills and a patient-focused mindset.

          Preferred
          • Experience supporting Neurology, Specialty Care, or Physician Practice environments.
          • Familiarity with medical insurance plans, authorizations, referrals, and copay collection processes.

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