Medical Specialist

About the role

As a Benefits Verification Specialist at Xploy Solutions, you will verify medical, workers' compensation, and auto benefit reports for primary and secondary payers for managed care patients. The role reports to the Director of Verifications.

Responsibilities

• Learn and understand the training provided during onboarding.
• Review the benefits queue 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 and an average of at least 65 verifications per day at 365 days.
• Keep turnaround time below 15 minutes per client verification request.
• Attend monthly one-on-one meetings with leadership and respond to client email requests by the end of the day.
• Support colleagues by handling additional verifications from the team's pool during downtime or a lull in your caseload.
• Communicate respectfully with colleagues and leadership, maintain 100% attendance, and follow HR policies for time clock use and PTO.
• Uphold and practice company principles (GUIDE) in work-related interactions.

Requirements

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

Datos clave

• The role verifies medical, workers' compensation, and auto benefit reports for managed care patients.
• A high school diploma or GED is required.
• The role reports to the Director of Verifications.