Insurance Benefits Specialist ID-8779

January 24, 2025

JOB SUMMARY:

The Insurance Benefits Specialist provides patients and physician offices with insurance benefit information. This position ensures timely verification of insurance benefits and financial clearance which has a direct impact to the organization's reimbursement from payers for patient accounts that are scheduled and unscheduled.

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SHIFT AND SCHEDULE:Full Time: Monday to Friday 8:00 am to 5:00 pm.

ESSENTIAL FUNCTIONS:

Performs financial clearance of patient accounts by verifying insurance eligibility and benefits and ensuring all notifications and authorizations are completed within the required timeframe.
Completes appropriate payor forms related to notification and authorization.
Coordinates the submission of clinical documentation from physicians to payers for authorization needs.
Calculates accurate patient financial responsibility.
Communicates timely with Utilization Review, and partners effectively with physician and facility staff to ensure financial clearance of the patient's account prior to scheduled or unscheduled service
Interprets complex payer coverage information including, but not limited to, network participation status with provider, limited plan coverage and inactive benefits.
Assists co-workers and clients with complex questions and issues.
Documents systems according to the Insurance Verification guidelines to assure accurate and timely reimbursement.
Manages workflow of specific area to ensure maximum results for department as requested.

KEY SUCCESS FACTORS:

2 years of healthcare or customer service experience or education equivalency required.
Must have the ability to consistently meet performance standards of production, accuracy, completeness and quality.
Ability to know and adhere to payer guidelines by plan and service type.
Requires good listening and communication skills, and professional telephone etiquette.
Ability to maintain a professional demeanor in a highly stressful and emotional environment.
Must be able to exhibit a high level of empathy with the ability to effectively communicate with patients, while demonstrating exceptional customer service skills.
Demonstrates ability to manage multiple, changing priorities in an effective and organized manner.
Excellent data entry, numeric, typing and computer navigational skills.
Basic computer skills and Microsoft Office.

BENEFITS:

401 K.
Medical, Dental and Vision.

REQUIREMENTS:

EDUCATION - H.S. Diploma/GED Equivalent.
EXPERIENCE - 2 Years of Experience.

About McEwen & Associates, Inc:

McEwen and Associates, Inc. is a medical services organization based in Irving, TX. We are committed to providing physicians and allied healthcare professionals with personalized and efficient service.

Insurance Benefits Specialist ID-8779

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Common Interview Questions And Answers

1. HOW DO YOU PLAN YOUR DAY?

This is what this question poses: When do you focus and start working seriously? What are the hours you work optimally? Are you a night owl? A morning bird? Remote teams can be made up of people working on different shifts and around the world, so you won't necessarily be stuck in the 9-5 schedule if it's not for you...

2. HOW DO YOU USE THE DIFFERENT COMMUNICATION TOOLS IN DIFFERENT SITUATIONS?

When you're working on a remote team, there's no way to chat in the hallway between meetings or catch up on the latest project during an office carpool. Therefore, virtual communication will be absolutely essential to get your work done...

3. WHAT IS "WORKING REMOTE" REALLY FOR YOU?

Many people want to work remotely because of the flexibility it allows. You can work anywhere and at any time of the day...

4. WHAT DO YOU NEED IN YOUR PHYSICAL WORKSPACE TO SUCCEED IN YOUR WORK?

With this question, companies are looking to see what equipment they may need to provide you with and to verify how aware you are of what remote working could mean for you physically and logistically...

5. HOW DO YOU PROCESS INFORMATION?

Several years ago, I was working in a team to plan a big event. My supervisor made us all work as a team before the big day. One of our activities has been to find out how each of us processes information...

6. HOW DO YOU MANAGE THE CALENDAR AND THE PROGRAM? WHICH APPLICATIONS / SYSTEM DO YOU USE?

Or you may receive even more specific questions, such as: What's on your calendar? Do you plan blocks of time to do certain types of work? Do you have an open calendar that everyone can see?...

7. HOW DO YOU ORGANIZE FILES, LINKS, AND TABS ON YOUR COMPUTER?

Just like your schedule, how you track files and other information is very important. After all, everything is digital!...

8. HOW TO PRIORITIZE WORK?

The day I watched Marie Forleo's film separating the important from the urgent, my life changed. Not all remote jobs start fast, but most of them are...

9. HOW DO YOU PREPARE FOR A MEETING AND PREPARE A MEETING? WHAT DO YOU SEE HAPPENING DURING THE MEETING?

Just as communication is essential when working remotely, so is organization. Because you won't have those opportunities in the elevator or a casual conversation in the lunchroom, you should take advantage of the little time you have in a video or phone conference...

10. HOW DO YOU USE TECHNOLOGY ON A DAILY BASIS, IN YOUR WORK AND FOR YOUR PLEASURE?

This is a great question because it shows your comfort level with technology, which is very important for a remote worker because you will be working with technology over time...

DISCLAIMER

Other Jobs You May Be Interested In

Insurance Benefits Specialist ID-8779

Common Interview Questions And Answers

1. HOW DO YOU PLAN YOUR DAY?

2. HOW DO YOU USE THE DIFFERENT COMMUNICATION TOOLS IN DIFFERENT SITUATIONS?

3. WHAT IS "WORKING REMOTE" REALLY FOR YOU?

4. WHAT DO YOU NEED IN YOUR PHYSICAL WORKSPACE TO SUCCEED IN YOUR WORK?

5. HOW DO YOU PROCESS INFORMATION?

6. HOW DO YOU MANAGE THE CALENDAR AND THE PROGRAM? WHICH APPLICATIONS / SYSTEM DO YOU USE?

7. HOW DO YOU ORGANIZE FILES, LINKS, AND TABS ON YOUR COMPUTER?

8. HOW TO PRIORITIZE WORK?

9. HOW DO YOU PREPARE FOR A MEETING AND PREPARE A MEETING? WHAT DO YOU SEE HAPPENING DURING THE MEETING?

10. HOW DO YOU USE TECHNOLOGY ON A DAILY BASIS, IN YOUR WORK AND FOR YOUR PLEASURE?

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