Benefit Verification Specialist

Manhattan Endoscopy Center (MECN), a GI focused Ambulatory Surgery Center (ASC) located in New York, NY, has an exciting opportunity for a full-time Benefit Verification Specialist to join their team!

What makes us awesome:

Perks and benefits offered to eligible employees

• No evening, on-call or holiday work hours.
• PTO – including: Vacation, Sick, Holidays, Bereavement, Jury, and Voting.
• High quality, cost effective Medical, Dental, Vison, and Prescription benefits.

What you’ll do:

Benefit Verification Specialists are responsible for the timely verification of medical insurance benefits. Calling private insurance companies, Medicare, and Medicaid to obtain benefit information, determining insurance compatibility with health-care provider programs, coordinating with patients regarding their insurance benefits and medical providers programs, re-verifying existing patient insurance coverage, and determining if an insurance benefit plan considers selected products appropriate based on patient need.

What you will be working on:

• Responsible for the timely verification of medical insurance benefits for the service scheduled or service being provided via website and/or calling the payor (Managed Care payors, Governmental payors and Commercial payors) obtain pre-certification and authorizations.
• Reviews and resolves preauthorization/precertification/referral issues that are not valid and contacts insurance carriers to verify/validate requirements to ensure accuracy and avoid potential denial.
• Validates that all necessary referrals, pre-certification and/or authorizations for scheduled service are on file and that they are valid for the scheduled test being performed
• Ensure all account activity is documented in the computer system timely and thoroughly.
• Identify and forward potential reimbursement problems to Billing Collections Team.
• Proactively interacts with utilization review and patient authorizations and initiating authorizations for add on procedures.
• Compliance with daily/weekly productivity reporting.
• Adheres to corporate compliance program, HIPAA and other regulatory requirements
• Performs other duties as needed or assigned.
• Communicates effectively and professionally with clients, visitors, physicians, and coworkers
• Interacts with professional staff, payors, patients, vendors, visitors and fellow employees in a mature, responsible manner to ensure a positive and professional facility environment
• Ensures that patient is aware of any copayments, deductibles, etc.
• Provide coverage for Front Desk when needed (e.g. register/arrive patients)
• Performs other miscellaneous office/clerical duties as needed

What you’ll know:

• A successful applicant must be legally authorized to work in the United States without sponsorship.
• Associates degree preferred, High School Diploma Required.
• Minimum of 1-year experience in patient access, registration, billing, insurance and or pre-certification.
• Experience with insurance carriers or third-party administrators are preferred.
• Previous experience with multiple phone lines, and routine front office equipment, e.g. fax, copier, postage machine.
• Above average computer skills needed, e.g. experience in all aspects of MS Office.
• Pre-employment physical with additional testing as required to meet OSHA standards.

Manhattan Endoscopy Center (MECN) partners with PE GI Solutions who provides over 600 gastroenterologist partners industry-leading practice and center management solutions across the nation. This includes a comprehensive business approach to compliance, operations, corporate services and clinical support. For more information about our partner, PE GI Solutions, please visit www.pegisolutions.com.

Diversity & Inclusion

We value diversity! We provide equal employment opportunities to all employees and applicants without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

Job Type: Full-time

Pay: $25.00 - $27.00 per hour

Benefits:

• Dental insurance
• Disability insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Weekly day range:

• Monday to Friday
• No weekends

Experience:

• Insurance verification: 1 year (Preferred)

Ability to Commute:

• New York, NY 10017 (Required)

Ability to Relocate:

• New York, NY 10017: Relocate before starting work (Required)

Work Location: In person