Funding Verification Specialist

This is a fully remote position, open to applicants in New Jersey.

📋 Description

• Obtain insurance benefit coverage through phone communication or online platforms.

• Analyze benefit coverage details to forecast expected client expenses.

• Assess the accuracy, completeness, and reliability of insurance benefit data.

• Evaluate case feasibility based on reimbursement policies, payer requirements, funding criteria, and likelihood of reimbursement.

• Identify funding options for device trials based on patient insurance plans.

• Detect and address potential coordination of benefits challenges.

• Verify benefits for precision prior to sale.

• Relay funding decisions, obstacles, and subsequent steps to internal teams, patients, and healthcare partners.

• Ensure meticulous and compliant documentation along with patient records in accordance with HIPAA and Medicare regulations.

• Share potential issues and concerns with team members.

• Monitor and analyze issues to aid in resolution and prevent recurrence.

• Perform data entry and administrative tasks connected to sales operations.

• Recognize and escalate urgent issues while following up on assigned tasks.

• Carry out additional responsibilities and special projects as assigned.

⛳️ Requirements

• High School Diploma or GED is required.

• A minimum of 3 years of experience in healthcare, insurance, DME, medical billing, benefits verification, or a related field is required.

• Proficiency with Medicare, Medicaid, and Commercial insurance is essential.

• Understanding of insurance plans, funding sources, and DME reimbursement methodologies.

• Strong skills in data entry, documentation, organization, and attention to detail.

• Capability to gather information, conduct research, and effectively resolve issues.

• Excellent verbal and written communication abilities.

• Empathy for individuals with disabilities, including those with speech impairments.

• Ability to establish rapport and maintain professionalism with clients, caregivers, providers, and internal stakeholders.

• Strong critical thinking, problem-solving, risk assessment, and decision-making capabilities.

• Capacity to exercise independent judgment and escalate complex or high-risk cases.

• Ability to manage multiple priorities in a dynamic, process-oriented environment.

• Flexibility to adapt to evolving priorities, processes, and business requirements.

• Demonstrated accountability, follow-through, initiative, and ownership of assigned tasks.

• An Associate's degree or an equivalent combination of education and experience is preferred.

• Background in customer service and/or administrative support is preferred.

• Familiarity with Microsoft Office, TrueSight, Inovalon, or HubSpot is preferred.

• Reliable and secure internet access for remote work is necessary.

• Must be authorized to work in the U.S.

🏝️ Benefits

• Opportunity for remote work from a home office.

• Comprehensive benefits package offered.

• Air travel up to 2 times per year within the U.S. for in-person team meetings and an all-company gathering.

• Reasonable accommodations available for individuals with disabilities.

• An inclusive and supportive workplace culture.

• Fair and equitable compensation practices.

• Commitment to career advancement and growth.