Verification specialist vs benefits advisor

Differences between verification specialist and benefits advisor duties and responsibilities

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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Benefits advisor example responsibilities.

• Manage broker and group accounts throughout the year administering qualify changes, terminations, and ACA compliance.
• Create reports using SQL database and manage reports, perform from internet-base tools for research projects need for client insight.
• Function as a liaison between the patient, hospital and governmental agencies to obtain documentation require for Medicaid eligibility determination.
• Maintain employee benefit records in HRIS system, including qualifying event records, personal information updates, and employment status changes.
• Evaluate patients for existing insurance coverage, federal and state assistance programs, or hospital charity application.
• Use tactful and effective interview techniques to obtain pertinent information to assure accurate eligibility determination for Medicaid.
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