The Role
Verify potential clients' insurance eligibility and benefits by contacting insurers to confirm deductibles, copays, coinsurance, authorizations and out-of-pocket maximums. Document information in company systems, communicate financial responsibility to internal teams, maintain HIPAA/42 C.F.R. Part 2 compliance and patient confidentiality, administer CPR if needed, and perform related administrative and travel duties.
Summary Generated by Built In
Title: Benefit Verification Specialist
Department: Admissions Division
Reports Directly To: Benefit Verification Manager
Reports Directly To: Senior Director of Operations
- Position Summary: Benefit Verification Specialists are responsible for verifying potential client insurance benefits and communicating coverage details to internal teams.
- Primary Duties And Responsibilities:
- Verify potential client insurance eligibility and benefits
- Contact insurance companies to confirm:
- Deductibles
- Copays
- Coinsurance
- Out-of-pocket maximums
- Authorization requirements
- Document insurance information accurately in company systems
- Communicate financial responsibility to internal teams
- Maintain HIPPA compliance and patient confidentiality
- Other duties as assigned.
- Essential Job Requirements:
- Education and Experience:
- High School
- Degree or equivalent required. College classes preferred
- Demonstrate excellent communication (written and verbal) skills required
- Comfortable working with the public
- Knowledge, Skills, and Abilities:
- Must be CPR certified and capable of administering CPR.
- Be an example of our core values daily and hold yourself accountable to Bradford standards, policies, and procedures.
- Communicate effectively both verbally and in writing with referrals, other members of management, coworkers, patients, potential patients, and families.
- Maintain appropriate professional boundaries and confidentiality, including a working knowledge of 45 C.F.R. “Health Insurance Portability and Accountability Act” and 42 C.F.R. Part 2 “Confidentiality of Alcohol and Drug Abuse Patient Records” with respect to patient and potential patient identifying information and health information. This position has unrestricted access to identifying information and health information concerning patients, potential patients’ and families’ needs and concerns.
- Must maintain a professional demeanor and appearance, must not appear impaired or disoriented, but rather present coherent and articulate speech, kept appearance, alert, oriented, and responsive to patients’, potential patients’, and families’ needs and concerns.
- Demonstrate knowledge of substance use and substance use disorders.
- Demonstrate computer skills and typing proficiency.
- Other duties as assigned.
- Physical Requirements:
- Able to walk approximately one-half mile within facility and on premises per eight hours.
- Able to continuously sit from one-half hour to four hours per eight hours.
- Able to ascend and descend stairs.
- Able to lift and move up to thirty pounds.
- Other Requirements:
- If recovering two years of continuous, verifiable sobriety. (See Sobriety Policy)
- Must be able to work in a constant state of alertness as to perform the job in a safe manner.
- Regular attendance; including conference calls and onsite meetings as necessary.
- Able to travel as needed.
- Must have reliable transportation.
- Able to work in a cooperative manner with coworkers, managers, potential patients, patients, and families.
- Pass a criminal background check.
- Maintain a valid driver’s license, personal automobile liability insurance, and a driving record permitting coverage under company’s automobile liability policy if necessary.
Skills Required
- High school diploma or equivalent
- College classes
- Excellent written and verbal communication skills
- Comfortable working with the public
- CPR certification and ability to administer CPR
- Working knowledge of HIPAA (45 C.F.R.) and 42 C.F.R. Part 2
- Computer skills and typing proficiency
- Ability to walk ~0.5 mile per eight hours, sit 0.5–4 hours, use stairs, and lift/move up to 30 pounds
- Regular attendance and ability to work scheduled hours (Tue-Sat 11am-8pm) and participate in calls/meetings
- Reliable transportation
- Valid driver's license, personal automobile liability insurance, and acceptable driving record if coverage required
- Pass a criminal background check
- Ability to travel as needed
- Demonstrated knowledge of substance use and substance use disorders
- Maintain professional demeanor, boundaries, and patient confidentiality
- If applicable, two years of continuous, verifiable sobriety (see Sobriety Policy)
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The Company
What We Do
Bradford Health Services has been treating alcoholism and drug addiction for almost 50 years. Our proven evidence-based approach is effective and affordable. Our mission is to bring hope to our patients and their families and lead them on the path of recovery. Bradford’s complete continuum of care offers individualized and structured care, focusing on physical, emotional and spiritual well-being. Bradford treats patients from across the nation from our inpatient, residential, partial or intensive outpatient treatment programs. We have facilities across United States. Our services are individualized to meet patients at their need.
