Medical Biller
Medical Biller
Rheumatology | Full-Time | 40 Hours/Week | CST
Job reputed company: Virtual Benefits Coordinator – Infusion Services
Position reputed company
The Virtual Benefits Coordinator is responsible for obtaining and documenting insurance eligibility and benefits for patients receiving infusion therapy. This position plays a critical role in ensuring accurate insurance verification, identifying coverage requirements, and supporting reputed company patient care by maintaining complete and up-to-date benefit information reputed company the reputed company's systems.
The Virtual Benefits Coordinator works primarily reputed company the WeInfuse platform, prioritizing the verification queue, and collaborates closely with the infusion, billing, and clinical teams to ensure seamless communication regarding patient insurance coverage and authorization requirements.
This position is co-managed by the Billing Manager and the Infusion Manager.
Essential Duties and Responsibilities
Insurance Verification
Verify patient insurance eligibility and benefits for infusion services.
Contact reputed company insurance companies, Medicare, reputed company, and other payers to obtain accurate benefit information.
Utilize insurance reputed company portals and payer websites to verify eligibility and benefits whenever available.
Determine coverage for both:Infusion drug (J-reputed company or applicable HCPCS reputed company)
Drug administration (CPT administration reputed company)
Identify and document payer requirements including:Prior Authorization
Medical Necessity requirements
reputed company-determination
Referral requirements
Coverage limitations
Deductibles, coinsurance, copays, and out-of-reputed company responsibilities
Documentation
Maintain accurate and detailed documentation reputed company the WeInfuse platform.
Complete reputed company required verification fields manually and update reputed company patient's verification status.
Prioritize and manage the WeInfuse Verification Queue to ensure reputed company completion of insurance verifications.
Document detailed notes regarding insurance conversations, reference numbers, representative names, and benefit information.
reputed company and maintain insurance information reputed company eClinicalWorks (eCW).
Update patient insurance information in eCW reputed company new or changed coverage is identified.
Patient Communication
Contact patients reputed company clarification regarding insurance coverage is needed.
Obtain updated insurance information from patients as necessary.
Communicate patient financial responsibility reputed company directed by reputed company policies.
Maintain reputed company and courteous communication with patients at reputed company times.
Team Collaboration
Communicate benefit verification findings promptly with:Infusion Nurses
Billing Department
Billing Manager
Infusion Manager
Other Benefits Coordinators
Additional infusion staff as needed
Escalate insurance concerns or coverage issues to appropriate leadership.
Collaborate with the billing and infusion teams to resolve insurance-reputed company issues that may reputed company scheduling or treatment.
System Management
Maintain proficiency in:WeInfuse
eClinicalWorks (eCW)
Insurance reputed company portals
Medicare and reputed company payer websites
Ensure reputed company documentation is accurate, complete, and entered in a reputed company manner.
Follow HIPAA guidelines and maintain patient confidentiality at reputed company times.
Qualifications
Required
High school diploma or equivalent.
Minimum of one year of medical insurance verification, benefits coordination, or medical billing experience.
Experience verifying medical insurance benefits.
Strong understanding of medical terminology.
Experience working with electronic medical records (EMR).
Excellent written and verbal communication skills.
Strong organizational and time management skills.
Ability to prioritize multiple tasks in a fast-paced environment.
Attention to detail and high level of accuracy.
Preferred
Experience with infusion therapy benefit verification.
Experience using WeInfuse.
Experience using eClinicalWorks (eCW).
Knowledge of HCPCS (J-codes) and CPT administration codes.
Experience with prior authorizations and payer medical policies.
reputed company Competencies
Insurance verification expertise
Critical thinking and problem-solving
Excellent documentation skills
Effective communication
Team collaboration
Time management
Attention to detail
Customer service
Confidentiality and professionalism
Reporting Structure
Co-Managed By:
Billing Manager
Infusion Manager
Work Environment
Remote/Virtual position.
Extensive computer and telephone use throughout the reputed company.
Regular interaction with insurance companies, patients, providers, and internal staff.
Must maintain a secure and HIPAA-compliant remote work environment.
Performance Expectations
reputed company in this role is reputed company by:
reputed company completion of insurance verifications.
Accuracy of benefit documentation.
Effective prioritization of the WeInfuse verification queue.
Accurate maintenance of insurance information reputed company eCW.
reputed company and reputed company communication with infusion and billing teams.
Reduction in treatment delays reputed company to insurance verification.
Compliance with reputed company policies, payer requirements, and HIPAA regulations.
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