Intake and Eligibility/Benefits Verification Specialist

Company Description

Gentell is a leading global provider of innovative, efficient, and affordable wound care solutions tailored to meet the individualized needs of patients in nursing homes, hospices, and hospitals. With clinical specialists across the United States and Canada, we offer expert recommendations and education to support proper use of wound care products. As one of North America's largest manufacturers of wound care supplies, Gentell operates production facilities in the United States, Canada, and China. Our comprehensive product line includes advanced and traditional wound care dressings and skin protection products, ensuring optimal patient care and outcomes.

Job Summary:

The Intake and Eligibility/Benefits Verification Specialist is responsible for gathering patient information, verifying insurance coverage, and ensuring eligibility for services. This role plays a critical part in the revenue cycle by preventing claim denials and ensuring accurate billing.

Key Responsibilities:

• Collect and review patient demographic and insurance information during intake.
• Verify insurance eligibility and benefits using payer portals, phone calls, or electronic systems.
• Confirm coverage for specific services, procedures, and authorizations as required.
• Communicate with payers regarding insurance benefits, out-of-pocket costs, and financial responsibilities.
• Document all verification details accurately in the system.
• Collaborate with clinical and billing teams to resolve discrepancies.
• Maintain compliance with HIPAA and organizational policies.

Skills & Qualifications:

• 12 years of experience in insurance verification or healthcare revenue cycle.
• Strong knowledge of medical terminology, insurance plans, and authorization processes.
• Excellent communication and customer service skills.
• Proficiency in EMR systems and payer portals.