Zealie is a fast-growing Medical Billing company specializing in the Behavioral Healthcare industry. Our clients are substance use disorder treatment, addiction recovery, and mental health treatment centers that are saving lives on a daily basis. Our state of the art proprietary technology provides data analytics and revenue prediction tools to our clients to help them make strategic business decisions to grow their business. We are committed to delivering exceptional products and services to our clients and believe that our team plays a crucial role in achieving this mission. We are seeking motivated individuals with a desire to be a part of a winning team.
Job Summary
A Verification of Benefits (VOB) Specialist
is responsible for verifying insurance coverage and benefits for patients before services are provided. This ensures that the healthcare provider knows the extent of the patient's insurance coverage, including co-pays, deductibles, and any out-of-pocket costs.
Key Responsibilities:
Verify Patient Insurance
Contact insurance companies via phone, online portals, or other methods to confirm insurance coverage.
Determine patient eligibility for services, coverage limits, co-pays, deductibles, and pre-authorization requirements.
Utilize portals ie: eVOB, Availity, Payer portals to cross check benefits and confirm accuracy of quoted benefits. Address any inconsistencies between online resources and Insurance company's representatives.
Documentation and Record Keeping:
Accurately document verified insurance benefits in the patient's medical record or billing system.
Maintain records of communications with insurance providers for future reference and audits.
Communication:
Communicate any discrepancies or issues with insurance coverage to Managers, the Billing department, UR Department and healthcare providers.
Provide patients with information about their financial responsibility based on insurance verification.
Coordination with Other Departments:
Work closely with billing, admissions, and clinical staff to ensure proper insurance handling.
Help resolve any issues with claim denials or insurance coverage problems.
Stay Updated:
Keep up-to-date with changes in insurance policies, regulations, and compliance standards.
Attend training or continuing education to maintain knowledge of industry standards.
Skills Required:
Strong attention to detail.
Excellent communication skills (both written and verbal).
Familiarity with medical billing systems, insurance portals, and claims processing software.
Knowledge of insurance terms (HMO, PPO, deductibles, co-insurance, etc.).
Ability to handle sensitive patient information in compliance with HIPAA regulations.
Qualifications:
High school diploma or Associate degree in healthcare administration or a related field.
Minimum of Three Years experience in a healthcare setting, particularly in insurance verification preferably Behavioral Health or medical billing.
Understanding of medical terminology and coding may be beneficial.
* This role is crucial in ensuring patients understand their insurance benefits, and healthcare providers receive appropriate payments from insurance companies.
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