Benefits and Eligibility and Account Specialist

Job DescriptionJob DescriptionDescription:

The Orthopaedic Eligibility & Benefits and Patient Account Specialist is responsible for verifying patients' insurance coverage, determining benefits ensuring accurate financial information prior to orthopaedic procedures or visits and collects payments from patients. Verify patient insurance eligibility and benefits (medical, surgical, therapy services) Confirm coverage for orthopaedic procedures (e.g., surgeries, imaging, physical therapy) Obtain prior authorizations and referrals when required Communicate patient financial responsibility (copays, deductibles, coinsurance) Provides telephone customer service in a high call volume environment by responding to patient billing questions as well as working payor denials and collections on patient accounts (as needed) Interpretation of Explanation of Benefits (EOB); responding to billing questions or requests for information; collecting patient balances Coordinate with insurance companies to resolve coverage issues Enter and update insurance information in electronic health records (EHR) Work closely with AR and clinical teams Ensure compliance with HIPAA and payer guidelines Document all verifications, authorizations and payments accurately Job Type Full-time Schedule 8:30 AM - 5 PM Monday to Friday (No weekends!) Work Location On site

Required:

Palm Beach Gardens location Benefits 401(k) Dental insurance Disability insurance Health insurance Life insurance Paid time off Vision insurance

Requirements:

Skills & Qualifications Knowledge of medical insurance plans (PPO, HMO, Medicare, Medicaid) Familiarity with orthopaedic procedures and terminology (preferred) Knowledge of CPT, ICD-10, and HCPCS coding (basic to intermediate) Strong attention to detail and accuracy Excellent communication and customer service skills Experience with EHR and practice management systems Ability to handle high-volume verification tasks Education & Experience High school diploma or equivalent (required) Associate degree in healthcare administration (preferred) 1-3 years of insurance verification or healthcare front-end experience