Benefits & Eligibility & Account Specialist
At Palm Beach Orthopedic Institute, we know that our employees are our best assets when it comes to providing exceptional orthopedic care to our patients. It's for this reason that we are dedicated to hiring the most qualified staff to uphold our standards of care.
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Benefits & Eligibility & Account Specialist
Job Title: Benefits & Eligibility & Account Specialist
Description
The Orthopedic Eligibility & Benefits and Patient Account Specialist is responsible for verifying patients’ insurance coverage, determining benefits ensuring accurate financial information prior to orthopedic procedures or visits and collects payments from patients.
- Verify patient insurance eligibility and benefits (medical, surgical, therapy services)
- Confirm coverage for Orthopedic procedures (e.g., surgeries, imaging, physical therapy)
- Obtain prior authorizations and referrals when required
- Communicate patient financial responsibility (copays, deductibles, coinsurance)
- Provides telephone customer service in a high call volume environment by responding to patient billing questions as well as working payor denials and collections on patient accounts (as needed)
- Interpretation of Explanation of Benefits (EOB); responding to billing questions or requests for information; collecting patient balances
- Coordinate with insurance companies to resolve coverage issues
- Enter and update insurance information in electronic health records (EHR)
- Work closely with AR and clinical teams
- Ensure compliance with HIPAA and payer guidelines
- Document all verifications, authorizations and payments accurately
Job Type
Full-time
Schedule
8:30 AM - 5 PM
Monday to Friday (No weekends!)
Work Location
On site Required: Palm Beach Gardens location
Benefits
- 401(k)
- Dental insurance
- Disability insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Requirements
Skills & Qualifications
- Knowledge of medical insurance plans (PPO, HMO, Medicare, Medicaid)
- Familiarity with orthopedic procedures and terminology (preferred)
- Knowledge of CPT, ICD-10, and HCPCS coding (basic to intermediate)
- Strong attention to detail and accuracy
- Excellent communication and customer service skills
- Experience with EHR and practice management systems
- Ability to handle high-volume verification tasks
Education & Experience
- High school diploma or equivalent (required)
- Associate degree in healthcare administration (preferred)
- 1–3 years of insurance verification or healthcare front-end experience
