The Benefit Verification Specialist will be responsible for performing all functions, from start to finish, to complete benefit verifications (BVs), prior authorizations (PAs) and other pre-authorizations for CND's commercial testing products. The Benefit Verification Specialist will work closely with other members of the Revenue Cycle Management team as well as Clinical Services on a daily basis.

Job Responsibilities:

• Collect and enter all patient and insurance information relevant to completing BVs, PAs and other pre-authorizations into CND's customer relationship management platform (Salesforce) and other locations in a highly accurate and timely manner
• Clarify incorrect or incomplete patient, insurance or other information that is necessary to complete BVs, PAs or other pre-authorizations
• Complete BVs, PAs and other pre-authorizations in a highly accurate and timely manner to fully meet the business needs of CND
• Fully utilize Waystar to batch process BVs and any other applicable pre-authorizations to reduce turnaround time, increase accuracy and drive efficiencies
• Regularly send completed BVs, PAs and other pre-authorizations to Clinical Services and other members of the Revenue Cycle Management team to allow them to communicate BV, PA and other pre-authorization results to patients and clinician customers and/or practices
• Regularly liaise with Clinical Services and other members of the Revenue Cycle Management team to support their functions related to BVs, PAs and other pre-authorizations
• Comply at all times with HIPPA and all other applicable regulations as well as CND's policies
• Other duties as assigned

Knowledge, Skills & Experience:

• Previous experience completing BVS, PAs and other pre-authorizations as well as medical billing experience
• Act in a highly compliant and professional manner at all times
• Understand and apply knowledge of the U.S. healthcare system as well as government and commercial U.S. health insurance and coverage
• Understand and apply knowledge of medical front office processes and terminology
• High attention to detail and highly accurate documentation of information
• Excellent verbal and written communication skills
• Strong customer service skills to be used in internal communications with the Revenue Cycle Management and Clinical Services teams
• Strong analytical skills to organize and interpret data and to enable problem solving
• Excellent poise and professionalism in verbal and written communication
• Strong ability to work effectively in fast-paced, dynamic team environments

Education, Certifications, and Licensures:

• High school diploma or GED certificate required
• Additional coursework or education (e.g., billing certificate, AA or bachelor's degree) with a focus on billing or related area preferred.

Other:

• Ability to use computers, software and related platforms as well as copiers, fax machines and scanners to create and maintain records
• Must possess the ability to sit or stand for long periods of time