What are the responsibilities and job description for the Benefits Specialist position at Tanyr Healthcare LLC?
The Benefits Intake Specialist performs duties to complete benefits for both inn and out of network insurances. They will also initiate authorization, Pre-D's, PCP referrals, GAPs, SCAs (Single Case Agreements) and LOAs (Letters of Agreements) when necessary, with a focus on accuracy, timeliness, and adherence to process. Understanding Medicare Criteria and Medical Policy reviews. We run monthly eligibility checks, research, and enroll patients in copay assistance program (if applicable), document in client system all outcomes.
At TANYR, we seek to add only ideal team players who can flourish in our culture and embody the characteristics of our Core Values:
Loyal to the Company: Care and concern for TANYR. Positive, selfless, and understands the value of reputation.
Hardworking: Strong work ethic, adaptive, committed, tenacious
Dedicated to Excellence: Passionate, attention to detail, think outside the box, self-starter.
Honesty and Integrity: Right demeanor, Accountable, do the right thing.
Faith: Family, help first
Performs Insurance verification of benefits coverage on all of patient’s insurance plans for each service being provided.
Obtains and documents in the system all information related to coinsurance, copay, deductibles, authorization requirements, etc.
Create documentation required to service the patient per policy and payer guidelines.
Determines estimated patient financial responsibility using insurance verification information and payer contract and/or self-pay guidelines.
Obtains initial authorization prior to admitting the patient for all services for any insurance plan that has authorization requirements.
Obtains reauthorization as necessary, reviews physician orders form pharmacy to determine if authorization is required on changes/additions to therapy for patient that are already on service.
Qualifications and Education Requirements
High School Diploma/GED with 1 year of experience in intake verification.
Microsoft Excel/Word
Outlook/Office 365
Working knowledge of CPR , Care Tend, Bright Tree, WeInfuse, Fuse Box, & Infuse Flow
Understanding of ICD-10, CPT and HCPCS codes.
Experience providing customer service to internal and external customers, including meeting quality standards of services and evaluation of customer satisfaction.
Strong organization and planning skills.