Benefit Verification Specialist I Job at Rogers Behavioral Health (Oconomowoc)

Job Description

The Benefit Verification Specialist I plays a key role in ensuring that front-end teams coordinating patient care have a clear understanding of each patient’s behavioral health insurance benefits prior to treatment. As the first step in the patient’s financial experience, this position verifies behavioral health benefits, determines patient financial responsibility, and communicates coverage information effectively to internal teams to support timely and accurate admissions and claims. The specialist is also responsible for identifying and correcting demographic errors daily, ensuring accuracy and compliance for all admitted patients.

Job Responsibility

Verify behavioral health insurance benefits for patients and potential patients
Spend significant time on the phone and online with insurance and managed care companies to confirm behavioral health coverage, limitations, referrals and authorization requirements
Use online payer portals as well as facility resources, managed care grids to accurately receive, interpret, and document benefit information
Accurately document quote of benefit details in Cerner, using correct dropdown selections, updating required fields, and assigning items to follow-up worklists as appropriate
Maintain high-level multitasking by actively working in multiple systems at once, verifying benefits, completing portal checks, correcting registration or demographic errors, and documenting results in Cerner
Audit demographic, insurance and financial data daily to ensure accuracy for encounters
Communicate with admissions, care coordination and utilization review teams to ensure accuracy of accounts
Identify potential coverage issues and escalate appropriately to avoid admission delays
Knowledge of Rogers programs and the facility’s admission, insurance authorization, and billing processes
Support departmental goals and team development
Participate in daily peer audits and huddles, providing and receiving constructive feedback in a professional manner
Maintain up-to-date knowledge of behavioral health payer policies, authorization requirements, and facility programs
Support patients and internal teams by addressing benefit-related questions promptly and accurately
Contribute to training efforts, uphold department policies and procedures, and demonstrate punctuality, professionalism, and teamwork

Requirements

High school diploma required
Minimum 1 year of experience in healthcare, insurance, patient access, billing, revenue cycle, or a related administrative role preferred
Experience with insurance verification, managed care plans, or behavioral health benefits strongly preferred
Computer skills required, including navigating multiple monitors, payer portals, EHR systems (Cerner preferred), Microsoft Office (Outlook, Word, Excel), and real-time documentation tools
High accuracy and attention to detail in data entry, documentation, and interpreting patient financial responsibility (deductibles, copays, coinsurance)
Strong communication and problem-solving skills, including professional phone etiquette with payers, clear written documentation, time-management, and critical thinking
Commitment to confidentiality and HIPAA compliance while handling sensitive patient and insurance information

What we offer

Health, dental, and vision insurance coverage for you and your family
401(k) retirement plan
Employee share program
Life/disability insurance
Flex spending accounts
Tuition reimbursement
Health and wellness program
Employee assistance program (EAP)

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Benefit Verification Specialist I

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