Insurance Benefits Specialist

Job Title: Insurance Benefits & Estimates SpecialistLocation: DrSnip – The Vasectomy Clinic (Remote/On-site, depending on location)Reports To: Practice Manager / Billing ManagerEmployment Type: Full-TimeAbout DrSnipDrSnip is a leading vasectomy clinic dedicated to providing simple, comfortable, and professional vasectomy care. Our mission is to make the process straightforward and stress-free for our patients—from consultation to recovery. We believe in clear communication, compassionate service, and accurate information every step of the way.Position SummaryThe Insurance Benefits & Estimates Specialist plays a critical role in ensuring patients have a clear understanding of their insurance coverage and expected costs before their vasectomy procedure. This position combines analytical precision, customer service excellence, and in-depth insurance knowledge to deliver accurate benefit estimates, verify coverage, obtain pre-authorizations, and help maximize insurance reimbursement for both the clinic and the patient.Key ResponsibilitiesEstimate Patient Financial Responsibility: Review patient insurance benefits and calculate estimated out-of-pocket costs (deductibles, copayments, and coinsurance) for vasectomy and related services. Verify Insurance Coverage: Contact insurance carriers to confirm eligibility, coverage details, and pre-authorization requirements for upcoming procedures. Obtain Pre-Authorizations: Facilitate the prior authorization process by submitting necessary clinical and coding documentation (CPT and ICD-10 codes) to ensure timely insurance approval. Communicate with Patients: Clearly explain insurance coverage and cost estimates, answer questions, and help patients understand their financial responsibility in a professional and empathetic manner. Resolve Claims and Billing Issues: Collaborate with the billing department and insurance carriers to address claim denials, underpayments, or discrepancies, ensuring accurate and timely resolution. Maintain Accurate Documentation: Enter and update insurance and benefit information in the clinic’s electronic health record (EHR) and billing systems with precision and confidentiality. Ensure Compliance: Adhere to HIPAA and all applicable federal and state regulations in handling patient information and insurance data. Track and follow up on unresolved billing issues, assist with resolution of claims appeals and reconsiderationsContribute to Continuous Improvement: Identify trends in coverage, denials, and patient concerns to recommend process improvements and enhance patient satisfaction. QualificationsEducation: High School Diploma required. Some college preferred. Equivalent experience in a medical billing or insurance verification role may be considered. Experience:Minimum of 1 year in medical insurance verification, benefits coordination, or healthcare billingGeneral proficiency in medical terminology Experience in a specialty clinic setting (urology, reproductive health, or outpatient surgical services) is a plus. Technical Skills:Proficient in navigation of various insurance portals, EHR platforms, and Microsoft Excel. Familiarity with CPT and ICD-10 coding, coordination of benefits, and payer-specific policies. Strong understanding of HIPAA, ACA, and general medical billing best practices. Core Competencies:Exceptional communication and customer service skills. High attention to detail and accuracy. Strong foundational math skills, analytical, and problem-solving ability. Ability to work independently while contributing to a collaborative team environment. Why Join DrSnip?Patient-focused, mission-driven team culture. Opportunities for professional growth in a respected, specialized clinic. Supportive environment that values accuracy, empathy, and transparencyCompensation & BenefitsBase Pay $27.00 per hour commensurate with experienceGenerous PTO policyRetirement MatchComprehensive Healthcare CoveragePowered by JazzHRR0F0TV3t7T