Insurance Benefits Specialist

Insurance Benefits & Estimates Specialist

Location : DrSnip The Vasectomy Clinic (Remote / On-site, depending on location)

Reports To : Practice Manager / Billing Manager

Employment Type : Full-Time

About DrSnip

DrSnip is a leading vasectomy clinic dedicated to providing simple, comfortable, and professional vasectomy care. Our mission is to make the process straightforward and stress-free for our patientsfrom consultation to recovery. We believe in clear communication, compassionate service, and accurate information every step of the way.

Position Summary

The Insurance Benefits & Estimates Specialist plays a critical role in ensuring patients have a clear understanding of their insurance coverage and expected costs before their vasectomy procedure. This position combines analytical precision, customer service excellence, and in-depth insurance knowledge to deliver accurate benefit estimates, verify coverage, obtain pre-authorizations, and help maximize insurance reimbursement for both the clinic and the patient.

Key Responsibilities

• Estimate Patient Financial Responsibility : Review patient insurance benefits and calculate estimated out-of-pocket costs (deductibles, copayments, and coinsurance) for vasectomy and related services.
• Verify Insurance Coverage : Contact insurance carriers to confirm eligibility, coverage details, and pre-authorization requirements for upcoming procedures.
• Obtain Pre-Authorizations : Facilitate the prior authorization process by submitting necessary clinical and coding documentation (CPT and ICD-10 codes) to ensure timely insurance approval.
• Communicate with Patients : Clearly explain insurance coverage and cost estimates, answer questions, and help patients understand their financial responsibility in a professional and empathetic manner.
• Resolve Claims and Billing Issues : Collaborate with the billing department and insurance carriers to address claim denials, underpayments, or discrepancies, ensuring accurate and timely resolution.
• Maintain Accurate Documentation : Enter and update insurance and benefit information in the clinic's electronic health record (EHR) and billing systems with precision and confidentiality.
• Ensure Compliance : Adhere to HIPAA and all applicable federal and state regulations in handling patient information and insurance data.
• Track and follow up on unresolved billing issues, assist with resolution of claims appeals and reconsiderations.
• Contribute to Continuous Improvement : Identify trends in coverage, denials, and patient concerns to recommend process improvements and enhance patient satisfaction.

Qualifications

Why Join DrSnip?

Compensation & Benefits