Verification of Benefits (VOB) Specialist – Ophthalmology Experience (Remote)
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AI Summary
Verify patient insurance eligibility, benefits, and coverage for a US-based ophthalmology clinic to minimize claim denials. Manage prior authorizations and communicate financial responsibilities to patients and clinic staff.
About the Role:
Snapscale is seeking a skilled Verification of Benefits (VOB) Specialist with Ophthalmology experience to support a US-based Ophthalmology clinic in a remote setup. This role is responsible for verifying patients' insurance eligibility, benefits, and coverage before services are rendered, ensuring accurate patient financial information, minimizing claim denials, and delivering a seamless patient experience. The ideal candidate has hands-on experience with U.S. insurance verification, prior authorizations, and Ophthalmology clinic workflows.
Key Responsibilities:
- Verify patients' vision and medical insurance eligibility, benefits, copays, deductibles, coinsurance, out-of-pocket maximums, and coverage limitations
- Verify patients' insurance eligibility and benefits with commercial insurance providers, Medicare, Medicaid, and other payers
- Perform comprehensive Verification of Benefits (VOB) prior to scheduled appointments to ensure accurate coverage information
- Determine prior authorization requirements and initiate authorization requests when necessary
- Contact insurance carriers to resolve eligibility discrepancies, benefit questions, and authorization issues
- Document insurance verification details accurately within the clinic's EMR/EHR or practice management system
- Communicate insurance coverage, patient financial responsibility, and missing information to clinic staff
- Assist with same-day insurance verification requests and scheduling exceptions
- Answer inbound calls and assist patients with insurance-related inquiries
- Schedule, reschedule, confirm, and follow up on patient appointments as needed
- Maintain accurate patient records while ensuring HIPAA compliance and adherence to clinic policies
Perks:
- Health Maintenance Organization (HMO)
- Competitive pay
- Government-mandated benefits
- 13th month pay
- Night differential pay
- Internet allowance
- Perfect attendance bonus
- Yearly salary increase
- Opportunities for career growth and development
Requirements
- Must have hands-on experience as a Verification of Benefits (VOB) Specialist supporting U.S.-based healthcare providers (required)
- Must have experience working with a U.S.-based Ophthalmology clinic or physician (required)
- Strong experience verifying insurance benefits with commercial insurance providers, Medicare, Medicaid, and other U.S. payers
- Strong understanding of U.S. health insurance plans and payer structures
- Knowledge of deductibles, copayments, coinsurance, out-of-pocket maximums, and prior authorization requirements
- Experience processing prior authorizations and communicating directly with insurance providers
- Experience using EMR/EHR systems and documenting insurance verification accurately
- Familiarity with CPT, ICD-10, and HCPCS codes is an advantage
- Medical billing and coding experience is a plus
- Strong written and verbal English communication skills
- Highly organized, detail-oriented, and able to manage multiple priorities in a fast-paced environment
- Strong customer service, analytical, and problem-solving skills
- Must be comfortable working in a remote setup with a reliable internet connection and dedicated workspace
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