Benefits and Eligibility Specialist

Arete Sleep Health is currently seeking a full time Eligibility and Benefits Specialist to join our expanding Benefits and Eligibility Team!

Areté Sleep Health, is a dynamic organization committed to the relentless pursuit of excellence in the delivery of high quality sleep medicine and total patient care. We are the employer of choice for professionals searching for an organization that recognizes employees who are intelligent, driven, and committed to excellence and continuous improvement. At Areté Sleep Health, enjoy a fulfilling professional career in which you make a difference in patients’ lives every day.

Our expanding network of locations makes long term career development and advancement possible. Explore our website at www.aretesleep.com to learn about this dynamic organization and to see a full listing of locations.

The Benefits and Eligibility Specialist is responsible for:

- Performing the appropriate processes to identify and verify patient eligibility and benefits.
- Utilizing available resources to obtain insurance coverage information for ordered services in a timely manner.
- Requesting and tracking prior authorizations required for covered services with government and commercial third-party payors.
- Acquiring all clinical information necessary to acquire authorizations.
- Understanding and complying with all governmental, regulatory and company billing and compliance regulations/policies including buy not limited to Medicare and Medicaid programs
- Follow-up with referring physicians to collect all outstanding clinical information required to process referrals.
- Identifying and reporting to management payer issues with regard to authorizations and eligibility and benefit verification.
- Coordinating all patient information and process paperwork including preparation of file for billing
- Developing and maintaining working knowledge of current DME products and services offered.
- Identifying and adhering to third-party payor payment terms as related to business.
- Performing other duties as required.



Position Requirements

Candidates are required to have the following:

- A High School Diploma or Equivalent.

- Working knowledge of managed care principals and philosophies.

- Excellent verbal and written communication skills.

- Excellent customer service skills.

- Proficiency in Microsoft Outlook, Word and Web applications.

- Ability to type proficiently (35+ wpm)

-   Must be professional, possess a high degree of detail-orientation and self-motivation,

and have a strong work ethic.

- Must possess a high degree of integrity and ability to maintain confidentiality with HIPAA 

guidelines and patient matters.

 

In addition, the following areas of experience are preferred:

 

- Insurance eligibility and verification experience

- Billing process and procedures experience