Verification of Benefits Specialist (Scarborough, ME)

National Sleep Therapy is looking for a Verification of Benefits Specialist to assist us at our Scarborough, ME location. 

Responsibilities include, but are not limited to:

• Verifying patient insurance eligibility for all equipment and services.
• Confirming authorizations for all insurances and managing patient account collections.
• Obtaining all initial pre-certifications and pre-authorizations as well as necessary information to do so.
• Ensuring all required documentation and compliance has met the specific insurance guidelines for each patient and health plan prior to claims submission.
• Following system protocol for managing all patient transactions from physician prescription to the creation of a proper and accurate Sales Order.
• Creating clear and detailed notes stating the patient's insurance policy terms within the company database system.

Skills and experience required:

• 2 + years experience working in medical billing setting.
• Working knowledge of medical equipment, medical terminology and medical reimbursement or HME insurance and billing.
• Experience in both commercial (insurance) and government (Medicare and Medicaid).
• Working knowledge of CMS rules and regulations related to billing and compliance.
• Experience utilizing electronic billing system.
• Understanding of insurance terms, contract language including HMO, PPO and percentage of charges and fee schedules.
• Thorough knowledge of auditing claims.
• Strong knowledge of appeal guidelines specific to individual insurances.
• Understanding of pricing and replacement of supplies and devices.
• Ability to learn and master new software programs quickly and with accuracy.
• Knowledge of Brightree and/or Remit Data a plus.
• Knowledge of Medicare DME supplier standards a plus.
• Strong analytical and research skills.
• Excellent verbal and written communication skills.
• Superior multi-tasking and time management skills in a fast-paced environment.
• Reliable transportation.

Compensation: Compensation based on experienceA local company, that provides sleep therapy solutions, is looking for a Verification of Benefits Specialist to assist us at our Scarborough, ME location.

Interested candidates should email with their resume (with VOB in subject) and references.