Verification of Benefits Rep/Service Center Administrator ON-SITE

Company: Ottobock
Location: Bonita Springs
Posted on: January 18, 2023

Job Description:

For more than a century, Ottobock has pursued the mission of helping people living with limb loss or mobility challenges regain or maintain their freedom of movement. We do this through the development of leading prosthetic, orthotic and wheelchair innovation and an unwavering commitment to delivering superior patient care experiences. As a growing healthcare company, we continue to invest in both our people and new service offerings. With more than 8,000 employees worldwide and 1,100 across North America, we are dedicated to advancing the O&P industry and improving the lives of the people served by it.

We are looking for a Service Center Administrator/Verifications of Benefits Representative at our Bonita Springs, FL location. In this position you will perform a dual role of maintaining the office for credentialing/regulatory purposes and supporting billing operations and Verification of Benefits. This is a single person office in a professional office building and the position requires the employee to work in the office Monday-Friday any 8 hour period between 7am 5:30pm .

The office address is: 4061 Bonita each Rd. STE 104 Bonita Springs, FL 34134

Summary:

The VOB Representative (+/-95% of total time) is responsible for answering incoming calls and obtaining all necessary information from referral sources to initiate accurate patient profiles. Also responsible for conducting timely and accurate verification of benefits and communicating insurance benefits information to the patient and to colleagues in field service. Achieves department goals for productivity and quality. Communicate with payors and provide insurance information to the patient or other sources as required.

The Service Center Administrator (+/-5% of total time) is responsible for the maintenance of the service center, monthly audits of on-site credentialing requirements, greeting visitors (Medicare, CHAP, city/local government representatives, payers, etc.) that are auditing the service centers credentials and other administrative duties as assigned.

VOB Representative Duties and Responsibilities:

* Perform insurance verifications and authorizations for orthotic and/or prosthetic devices to ensure coverage for each code used for each device ordered for a patient.
* Collaborate with other team members and communicate requirements pertaining to their patients insurance coverage.
* Communicate accurate benefits to the patient or applicable customer.
* Communicate co-insurance and deductible amounts to the patient or applicable customer and collect if possible.
* Process all authorization requests required by the patients insurance carrier through live communication via phone with carriers or using insurance carrier online portals to obtain the most up-to-date benefit information.
* Create patient account profile in the billing system, manage the collection of medical documentation required to secure authorization for patient cases across all offices, and update the patient file with appropriate notes accordingly.
* Use active verbal and written communication of payor medical necessity requirements with clinical and non-clinical staff.
* Communicate any changes in requirements for verification or authorization by insurance carriers to the Manager/Supervisor for training and compliance updates.
* Provide problem-solving approaches to claim verification and authorization processes and formulates a plan of action for training considerations by the Manager/Supervisor.
* Answer calls in a timely and professional manner and provides signature customer service.
* Participate in training programs for continuous learning and development.
* Adhere to HIPAA and PHI Regulations.
* Observe and communicate to management any opportunities to streamline processes and improve efficiency in day-to-day operations.
* Perform other duties as assigned.

Service Center Administrator Duties and Responsibilities:

* Maintain the Service Center in accordance with all established standards required by Payers, Local and Federal Governments, Accrediting Agency, and Ottobocks Policies.
* Audit the service center per accreditation requirements and company standards monthly and submit audit paperwork to the Compliance Specialist.
* Correct deficiencies as they are identified.
* Consistently demonstrate professional demeanor (including dress code, company property use, etc.).
* Greet visitors and participate in successfully completing regulatory and/or accreditation site visits/audits.
* Additional duties as assigned.

Required Skills/Abilities:

* Ability to work independently.
* Ability to prioritize and manage multiple tasks to completion.
* Outstanding verbal and written communications skills.
* Exceptional organizational skills.
* Exceptional communication/interpersonal/teamwork skills.
* Minimum typing of 45 wpm; Excellent ten-key skills.
* Professional telephone manner: Ability to hear, communicate and comprehend by telephone for prolonged periods.
* Advanced problem-solving skills and demonstrated ability to use good judgment in resolving customer service issues.
* Ensures assigned work is complete and accurate by the end of work shift daily, weekly, and monthly.
* Strong computer skills; Proficient in MS Office and databases.

Education and Experience:

* High school diploma or equivalent required; Associate degree in a relevant field preferred.
* Minimum 2 years experience in medical billing, preferably with orthotics, prosthetics, and/or durable medical equipment industry.
* Experience with HIPAA regulations and Medicare and insurance carrier websites.
* Experience utilizing Healthcare Common Procedure Coding (HCPCS) and International Classification of Diseases (ICD) 10 billing codes.

Physical demands and working conditions:

The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee works in a temperature-controlled office environment. The noise level in the office work environment is usually moderate.

Ottobock is an Equal Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, national origin, sex, gender identity, sexual orientation, disability, protected Veteran status, age, or any other characteristic protected by law.

Keywords: Ottobock, Bonita Springs , Verification of Benefits Rep/Service Center Administrator ON-SITE, Other , Bonita Springs, Florida