Benefits specialist Jobs in Madison, WI

divh2Benefits Specialist Lead / h2pThe Benefits Specialist Lead is responsible for verifying patient insurance coverage, submitting pre-authorizations, and financial assistance support to ensure patients receive coverage for medical and infusion services provided. / ppKey Responsibilities : / pulliVerify and document insurance eligibility, benefits, and coverage for all office visits and infusion services. / liliObtains insurance authorization and pre-certification for office visits and infusion services. / liliFacilitate insurance denial mitigation steps such as peer-to-peer reviews and appeals. / liliMaintains a good working knowledge of infusion drug authorization requirements for all payers, state and federal regulatory guidelines for coverage and authorization. / liliCalculate and communicate patient financial responsibility. / liliProvide financial assistance support to patients including identifying patient assistance programs and manufacturer copay assistance enrollment. / li / ulpQualifications : / pulliHigh school diploma or equivalent / lili2-3 years of experience in medical insurance verification and prior authorizations. Experience in infusion services is preferred. / liliKnowledge of insurance terminology, plan types, structures, and approval types / liliPrevious experience with J-codes, CPT and ICD-10 coding / liliPrevious Athena use a plus, but not a requirement / liliKnowledge of medical terminology and clinical documentation review / liliStrong organizational skills / liliDetail-oriented / liliAbility to multi-task and work well in a fast-paced setting / liliCritical thinking skills and decisive judgment / li / ul / div