Nucleus Healthcare Hiring for Verification of Benefits Specialist Job at King of Prussia, PA Full Time

The Verification on Benefits (VOB) Specialist is responsible for checking eligibility for all RCA patients seeking treatment in any of our programs. The process for verifying benefits includes using online tools, contacting insurance companies via telephone to verbally verify benefits, assisting all Mission Center staff in the education of our potential patients benefits and/or assisting in all day to day processes involving insurance.

The VOB specialist will exercise compassion and care in every single interaction while working expeditiously to provide accurate eligibility checks for our patients seeking treatment from drugs and alcohol.

Specific Responsibilities:

• Responsible for full census of all our inpatient facilities, and 100% capacity utilization of our outpatient/MAT programs
• Promptly receives and processes prospective patient’s insurance benefits
• Follows defined policies and procedures, responsible for all phases of the verification of benefits process from ascertaining viability to procuring the benefit.
• Uses online and telephonic systems to verify prospective patients benefits.
• Ensures benefit documentation is accurate in the salesforce.com system and other related systems/technologies
• Responsible for documentation and communication of benefits, including co-pays, deductibles, and all other out-of-pocket expenses.
• Works collaboratively with the Contact Center staff, field sales team, the facility, and professionals in the community to support desired outcome for the patient
• Adheres to all regulatory and compliance policies while exhibiting compassion, professionalism, and care for the client always.
• Adheres to quality assurance guidelines as evidenced by monthly call reviews, daily maintenance of all systems, email, staff communication, and maintains up to date required training.

Education and Experience:

• High school or GED Required
• Experience working with commercial insurance and CMS
• Proficiency in Microsoft office
• Demonstrated experience providing empathetic, compassionate, and professional care for individuals in need
• Experience using Salesforce, Navinet, Availity, and/or Passport Health
• Experience (professionally or personally) in the treatment of addiction or mental health
• Excellent verbal and written communication skills required
• Excellent organizational skills with the ability to prioritize workload and meet deadlines.
• Must be able to work in a fast-paced environment with demonstrated ability to juggle multiple competing tasks and demands.
• Exceptional analytical and problem-solving skills.
• If in Recovery, must have 19 months of continuous sobriety

Knowledge/Skills/Abilities:

• Excellent interpersonal skills with the ability to provide constructive feedback to staff
• Strong analytical, problem solving, decision-making and time management skills
• Ability to plan well and prioritize work
• Ability to work independently and within a team
• Ability to work under pressure
• Proficient documentation skills
• Incredible listening skills
• Ability to multi-task and appropriately prioritize responsibilities in a fast-paced environment, with strong focus on attention to detail, and excellent communication skills
• Accurate and fast computer skills