Benefit specialist vs verification specialist

Differences between benefit specialist and verification specialist duties and responsibilities

Benefit specialist example responsibilities.

• Manage various employee program such as life, medical, dental pension, and HSA accounts.
• Examine HMO documents to verify eligibility to process or reject into or from a manage care plan when necessary.
• Input daily time and PTO, manage benefits, report new hires, input sales, oversee accounts receivable.
• Create reports using SQL database and manage reports, perform from internet-base tools for research projects need for client insight.
• Implement new vendor for FSA administration and manage outstanding issues through continuous follow-up and vendor accountability.
• Analyze, process and manage FMLA claims to determine eligibility and certification in compliance with state and federal regulations.
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Verification specialist example responsibilities.

• Manage the TRICARE information program by presenting information utilizing available media, group presentations, or mailings.
• Maintain confidentiality of all patient medical information adhering to HIPPA regulations and Medicare / Medicaid policies.
• Verify primary insurance eligibility by phone with agents or online regarding Medicaid recipients and to determine payment responsibilities to providers.
• Verify medical coverage and benefits to providers and members, review certain ICD9 and CPT codes.
• Verify patient effective date of insurance, including CPT and diagnosis codes and general policy information.
• Receive extensive training on insurance plans and types, HIPAA compliance, PatientPlus programming and other workplace relate topics.
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