Slp Remote Insurance Review Jobs in Boca Raton, FL

Remedial Pro

Location: Remote, Hybrid, or Onsite
Employment Type: Full-Time

Remedial Pro is dedicated to delivering exceptional support and operational excellence within the healthcare industry. We are seeking a highly motivated Verification of Benefits (VOB) Specialist to join our growing team and play a critical role in ensuring accurate and timely insurance verification for clients seeking care.

Job Summary:

The primary goal is to be responsible for insurance verification processes of verifying patient eligibility, coordinating medical benefits, gaining approval for planned procedures and services, and determining patient coverage/responsibility for services to be provided.

JOB DUTIES:

•  Maintains patient demographic information and data collection systems.
• Verify private, government and third party insurance information, including eligibility, out-of-pocket costs, prescription coverage and patient portions.
• Verify any secondary and tertiary medical insurance benefits.
• Obtain, review and input insurance authorization and referrals prior to patient services, and throughout treatment to maintain continuance of authorizations. Advocate for the patient utilizing knowledge of coverage based guidelines and treatments.
• Provide accurate and timely estimated patient responsibility amounts to patient service staff members.
• Monitor and track patient authorizations, obtain updated authorizations for ongoing treatment, and communicate changes to appropriate team members.
• Identifies and provides accurate CPT/ICD codes where needed for reimbursement.
• Maintain appropriate logs and reports to professional, state and federal requirements; including but not limited to Medicaid, Medicare, case logs and drug logs.
• Obtains, interprets and submits clinical documentation pertinent to the specific services requiring prior authorization to support medical necessity reviews by the payer.
• Follows up on denied authorization requests, escalates to appointed appeal personnel, and relays the necessary denial detail to the provider to facilitate the appeal and/or peer to peer reviews.
• Work closely with Billing Director and colleagues to ensure smooth collection process.
• Maintains appropriate documentation in clinic systems and EMR.
• Demonstrates a professional, proactive attitude, establishes and maintains effective channels of communication within the Company as well as with clients, and office based team members
• Provides excellent customer service to all constituents
• Document, maintains proficiency in all support functions and activities to ensure office operations are met
• Meets and maintains HIPAA regulations in regards to Protected Health Information
• Regular attendance and punctuality.
• Contributes to team effort by accomplishing related results as needed.
• Ensures that all processing and reporting deadlines are consistently achieved.
• Perform any other functions as required by management.

• Remote, hybrid, or onsite work options
• Competitive compensation
• Professional development opportunities
• Supportive and collaborative culture
• Opportunity to make a meaningful impact in healthcare operations

Benefits: 

• Health Insurance
• Dental Insurance
• Vision Insurance
• Paid Holidays
• 401(k) with Company Matching
• Professional Development Opportunities
• Remote, Hybrid, or Onsite Flexibility

Remedial Pro is an Equal Opportunity Employer and is committed to fostering an inclusive workplace. All qualified applicants will receive consideration for employment regardless of race, color, religion, sex, national origin, age, disability, veteran status, or any other protected characteristic.

Basic Life Support Certification required.

Minimum of 2 years in this field or related field such as medical coding, financial counseling setting or similar service profession.

Strong knowledge of ICD9/10 diagnosis codes, as well as CPT codes.

Must be proficient using a computer, online websites, and email.

Knowledge of basic medical terminology

Ability to work a flexible schedule (including overtime, and weekends, as necessary).

High school graduate or equivalent

Proficient computer skills, including familiarity with common programs, such as Microsoft Office Suite.

 Ability to collaborate across departments and build effective relationships with internal and external

customers to achieve goals.

Ability to be proactive and take initiative.

Exhibit high level of quality through attention to detail and monitoring of work.

•Ability to work independently on assigned tasks, as well as to accept direction on given assignments.

SUPERVISION EXERCISED:

• This position has no supervisory responsibilities.

• Work is performed in an office setting.
• Prolonged periods sitting at a desk and working on a computer.
• Must be able to lift up to 15 pounds at a time.
• Physical demands of position: sitting, standing, walking, typing, phone communication, face to face conversation.

• Remote, hybrid, or onsite work options
• Competitive compensation
• Professional development opportunities
• Supportive and collaborative culture
• Opportunity to make a meaningful impact in healthcare operations

Benefits: 

• Health Insurance
• Dental Insurance
• Vision Insurance
• Paid Holidays
• 401(k) with Company Matching
• Professional Development Opportunities
• Remote, Hybrid, or Onsite Flexibility

Remedial Pro is an Equal Opportunity Employer and is committed to fostering an inclusive workplace. All qualified applicants will receive consideration for employment regardless of race, color, religion, sex, national origin, age, disability, veteran status, or any other protected characteristic.