Benefits Specialist

About Reliable Respiratory

We are a Durable Medical Equipment (DME) company providing top-tier services for patients needing respiratory, diabetes, urology, and maternity support equipment. Our offerings include CPAPs, BiPAPs, AutoPAPs, nebulizers, oxygen equipment, ventilators, CGM devices, insulin pumps, and breast pumps. We treat each patient with professionalism, empathy, and attentive service.

Job Purpose

The Benefits Specialist updates patient insurance and demographic information, obtains benefits and eligibility information from insurance companies, and ensures successful claim payments. They also provide exceptional service to patients, payors, providers, and team members.

Duties And Responsibilities

• Provide exceptional service every time.
• Meet or exceed annual performance indicators as outlined by organizational leadership.
• Complete assigned tasks and worklists in a timely manner.
• Update patient demographics and ensure patient charts are up-to-date and accurate.
• Update patient insurance policies in Reliable Respiratory’s electronic health record system and task the associated team to update any renting sales orders, existing prior authorizations, and/or CMNs (Certificate of Medical Necessity).
• Verify patients' insurance eligibility, including contacting payors to investigate and verify the terms and benefits of patients' insurance policies and costs.
• Work with the team to maintain the process document verifying in-network and out-of-network insurances for billable HCPC and procedure codes.
• Handle incoming communications from customers and referrers in a timely, professional, and friendly manner.
• Comply with all policies and procedures established by the company and the company's regulatory bodies.
• Actively participate in meetings as necessary.
• Perform other duties and special projects as assigned and directed.

Basic Qualifications

• Eligible to work in the United States and not require work authorization from us now or in the future.
• At least 18 years old.
• A minimum of an associate’s degree or 2 years of relevant (authorization, claims, billing) experience.

Required Skills

• Effective problem-solving skills.
• Attentive listening and active listening skills.
• Decision-making ability under pressure.
• Excellent verbal and written communication skills.
• Strong attention to detail.
• Proficiency in computer applications (especially Microsoft Office Suite).
• Ability to work independently and collaboratively.
• Ability to prioritize and manage work amid interruptions.
• Compliance with internal and industry-imposed guidelines/regulations.

Competencies

• Customer Service Ethics
• Organization Skills
• Productivity
• Results Driven