VOB Specialist, PCP Verification & Appeals
Overview
Own insurance benefit verification and authorization workflows for a healthcare innovator with operations in over 160 countries. You will contact insurers, initiate pre-authorizations and referrals, file appeals for denied coverage, and keep patient records precise in the practice management system. This contract role sits on a collaborative team coordinating with clinical and billing departments to support patient care. What sets this position apart: direct exposure to Medicare rules and managed care contracting in a high-volume environment.
What You'll Do7
- 1Contact insurance companies to verify benefits and confirm coverage details for new and ongoing services.
- 2Initiate Pre-authorization, PCP referral, and Letter of Agreement requests, then follow up with insurers until resolution.
- 3File appeals for denied coverage, documenting every interaction and outcome.
- 4Maintain accurate customer records in the practice management system, tracking benefits, authorizations, denials, and appeals.
- 5Coordinate with internal departments to gather data needed for verification, authorization, and appeals.
- 6Provide patients with status updates on authorizations, cost estimates, and collect co-pays when applicable.
- 7Apply Medicare guidelines and managed care policies to process cases and respond to correspondence.
Requirements7
- 11+ years in insurance benefits verification, collections, or managed care contracting.
- 22+ years preferred in verification or authorization roles.
- 3High school diploma or GED required.
- 4Solid understanding of Medicare rules and regulations.
- 5Knowledge of managed care as it relates to benefits and authorizations.
- 6Advanced MS Office skills with strong verbal and written communication.
- 7Ability to work under pressure and meet deadlines.
Salary Insight
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