Medical Specialist

About the role

Xploy Solutions is seeking a Benefits Verification Specialist. The role involves thoroughly verifying medical, workers' compensation, and auto benefit reports for primary and secondary payers for managed care patients. The specialist reports to the Director of Verifications.

Responsibilities

• Learn and understand the training provided upon onboarding.
• Review the queue of benefits for open client requests throughout the day and manage requests using Guided Care software.
• Complete an average of 65 verifications per day at 90 days of hire, and 85 or more per day after 120 days.
• Maintain an error rate of fewer than 2 per month after 120 days of hire, and an average of 65 or more verifications per day at 365 days of hire.
• Complete each client-requested verification in less than 15 minutes.
• Participate in monthly 1:1 meetings with leadership.
• Collaborate with colleagues and help handle additional verifications from the team's pool during downtime or a lull in individual caseload.
• Communicate respectfully with colleagues and leadership, and respond to all client requests by email by the end of the day.
• Maintain 100% attendance and manage time clock and PTO requests according to HR policies.
• Uphold and practice company principles (GUIDE) in all work-related interactions.

Requirements

• High school diploma or GED.
• Independent and self-motivated.
• Ability to multitask, including data entry and phone conversations simultaneously.
• Innovative, detail-oriented professional with strong research and organizational skills.
• Able to thrive in a fast-paced, high-pressure environment.
• Strong collaboration skills with the team and clients, and ability to work autonomously.
• Strong time management and proven ability to meet deadlines.
• Ability to communicate and exchange information and ideas so others will understand.

Datos clave

• Requires a high school diploma or GED.
• Uses Guided Care software to manage client verification requests.
• Target averages are 65 verifications per day at 90 days of hire and 85 or more after 120 days.