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Benefits Verification Specialist

Cary, NC

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RemX is accepting applications for new and experienced Benefits Verification Specialist for an amazing opportunity in Cary, NC. The experienced candidate will be responsible for one or more of the following activities: first/third party billing utilizing the patient financial information system, adjudicating claims, follow-up reviews, processing/tracking of submissions, remittances and rejections, inpatient/outpatient registration, cashiering, credit and collections, charge master maintenance, follow-up with insurance companies and patients to ensure that all patient accounts are paid in a timely fashion. Also responsible for performing a wide variety of duties to provide for the efficient and effective management of accounts receivable. 

Essential Duties and Responsibilities

• Manage Enterprise Lists within CPR+(Salesforce).
• Process a designated amount of new patients daily by accurately inputting information into the system.
• Make outbound calls to various payers to complete the benefits verification process. 
• Process any follow-ups in your name by due date.
• Answer patient and provider calls as they come in to the ACD line.
• Verify patients’ insurance benefits for prescribed therapy.
• Provide prior authorization support for health care provider to ensure they have complete information initially.
• Communicate with providers and other team members regarding patient updates and changes so that they stay abreast of the patient’s status.
• Accurately provide an explanation of the benefit plan to patients and providers to ensure understanding of payment responsibility.
• Screen patients for free drug, copay assistance, and copay card eligibility based on client guidelines and business rules.
• Triage patient referrals to appropriate Specialty Pharmacy per coverage determination confirming complete information is being sent to eliminate back and forth communication.
• Accurately enter progress notes for patients so that other team members can access the status of a patient easily.

Job Requirements


• High School diploma or equivalent. College degree is preferred.
• At least 3+ years of experience working and understanding Insurance Verification/Benefits.
• Strong verbal and written skills to effectively communicate with co-workers and medical office personnel.
• Strong organizational/computer skills.
• Proficiency in Microsoft Applications. Basic knowledge in Excel.
• Excellent Customer Service Skills.
• Ability to effectively work with people.
• Highly motivated and committed to excellence with a positive attitude.
• Strong organizational skills, ability to prioritize and work under pressure.
• Flexible, adaptable, conscientious and detail oriented.
• Entrepreneurial approach to bring new ideas to our service and solutions.

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