health benefits specialist

Hutchinson Clinic

<div><div><div><b>Job Summary:</b><br>
The HR Benefits Specialist is responsible for coordinating and maintaining the day-to-day administration of group benefits programs (health, dental, vision, short-term and long-term disability, worker's compensation, life insurance, accident plan, flexible spending plan, retirement plans, etc.) for employees &amp; physicians. The HRBP researches and recommends improvements for benefits and monitors benefits administration and compliance.</div></div><div><div><b>
Essential Functions and Responsibilities:</b></div></div><ul><li><div>
Serve as primary contact for benefit brokers, plan vendors and third-party administrators.
</div></li><li><div>Coordinate transfer of data to vendors and auditors for services, premiums, and plan administration.
</div></li><li><div>Coordinate scheduled benefits processing. Process enrollments, changes, COBRA, terminations, beneficiaries, disability, accident and death claims, rollovers, distributions, loans, hardships, and compliance testing.
</div></li><li><div>Gather employee data and oversee the processing of monthly billings and the preparation of vouchers for payment of administrative fees for all group plans.
</div></li><li><div>Ensure compliance with applicable government regulations. Ensure timeliness and accuracy of required reporting and fees.
</div></li><li><div>Provide customer service support to internal and external customers. Develop communication tools to enhance understanding of the company's benefits package.
</div></li><li><div>Oversee maintenance of employee benefits files, maintain group benefits database and update employee payroll records.
</div></li><li><div>Document and maintain administrative procedures for benefits processes.
</div></li><li><div>Perform plan audits. Prepare, collect, and organize data for actuarial assessments. Review data in conjunction with actuarial evaluation task forces.
</div></li><li><div>Prepare monthly briefings and provide recommendations for agenda items for VP of HR ahead of Benefits committee meetings.
</div></li><li><div>Evaluate and revise internal processes to reduce costs and increase efficiency. Advise the VP of HR of recommendations related to Benefits.
</div></li><li><div>Design and distribute materials for benefits orientations, open enrollment, and summary plan descriptions.
</div></li><li><div>Complete benefits surveys and process results. Develop recommendations for review for Administration &amp; Benefits Committee
</div></li><li><div><div>Working with broker, analyze benefits, evaluate services, coverage, effectiveness, cost, plan experience and trends in benefits.
</div></div></li><li><div>Review both short- and long-range cost estimates/projections and relevant statistical analyses regarding modifications in benefits programs and implementation of new programs.
</div></li><li><div>Recommend and implement new benefits programs. Examine possible plan designs and benefits cost changes.
</div></li><li><div>Cross train in Human Resources areas to support HR team.
</div></li><li><div>All other duties as assigned.
</div></li></ul><div><div><b>Additional Responsibilities:</b></div></div><ul><li><div>
Maintain compliance with Clinic policies and procedures.
</div></li></ul><div><div><b>Knowledge &amp; Skills:</b></div></div><ul><li><div>
Experience: Two to four years employee benefits experience in HR setting. Prefer HRIS experience in Paycom or similar HRIS system. Requires strong customer service focus - prefer experience with physicians. Requires strong attention to detail.</div></li><li><div>
Education: Bachelor's degree in Human Resources or related field. Will consider Associate degree + 2 years of HR benefits experience in lieu of bachelor's degree. SHRM certification preferred.
</div></li><li><div>Other Skills: Organization - proactively prioritizes organizational needs and effectively manages resources. Computer skills - demonstrates intermediate proficiency in Microsoft Office applications. Ability to motivate or influence others. Must possess excellent verbal and written communication as well as excellent interpersonal skills with staff, health care professionals and outside contacts.
</div></li></ul><div><div><b>Physical Requirements:</b></div></div><ul><li><div>
Prolonged periods sitting at a desk and working on a computer. Must be able to lift up to 15 pounds at a time.</div></li><li><div>
Flexibility to work in a physical office or other remote location.
</div></li></ul><div><div><b>This Job Description is not a complete statement of all duties and responsibilities comprising the position.</b></div></div></div>

Benefits Specialist

McDaniel College

<div></div><div><div><div><div><div><div><div><div><b>Benefits Specialist<br>
</b></div></div><br>
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<br>
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<p></p><div><div><div><div><br>
<div><div>Category:</div> <div>Staff</div>
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<div><div>Department:</div> <div>Human Resources</div>
</div><br>
<div><div>Locations:</div> <div>Westminster, MD</div>
</div><br>
<div><div>Posted:</div> <div>Apr 10, 2026</div>
</div><br>
<div><div>Closes:</div> <div>Open Until Filled
</div></div><br>
<div><div>Type:</div> <div>Full-time</div>
</div><br>
<div><div>Salary Type:</div> <div>Annually</div>
</div><br>
<div><div>Salary Range:</div> <div>$59,000.00 - $59,000.00</div>
</div><br>
<div><div>Position ID:</div> <div>199370</div></div><div></div><div><div><br>
</div></div><br>
</div></div><p>About McDaniel College:<br>
</p><p>McDaniel College is a four-year, independent college of the liberal arts and sciences offering over 100 undergraduate and graduate programs. One of the original &quot;Colleges That Change Lives,&quot; McDaniel emphasizes experiential learning and student-faculty collaboration to develop the unique potential in every student. Represented by the Green Terror, over 20 athletic teams compete in the NCAA Division III Centennial Conference. A student-centered community of 1,600 undergraduates and 1,400 graduate students offers access to both Baltimore and Washington, D.C., plus a European campus in Budapest, Hungary.</p>
<p>This position has a budgeted hiring rate of $59,000. The position is classified as an A3. The A3 salary band for all full-time, 12-month positions at the college with this classification have a minimum rate of $45,000 and a maximum rate of $70,312. For benefit purposes only, the workweek is estimated to be 35 hours per week. The actual schedule for exempt positions may vary based on the workload and responsibilities assigned.</p>
<p>At McDaniel College we value our employees by offering our full-time employees tuition remission, 403B retirement accounts, paid time off, medical insurance, flexible spending accounts, life insurance, and paid maternity and parental leave. For more information about the college's benefits, please click here to review the 2026 benefits guidebook and click here to view 2026 premium rates.</p><br>
<p></p><p><br>
Job Description:<br>
</p><p>The Benefits Specialist, under the general direction of the Director of Human Resources, is responsible for the administration, coordination, and maintenance of employee benefit programs. This role ensures accurate and compliant benefits processing, provides employee guidance and support, maintains benefit-related records and reporting, and collaborates with internal and external partners to deliver responsive and high-quality benefits services.</p>
<p>Responsibilities include but are not limited to:</p>
<ul><li>Administers college benefit plans, including health, dental, vision, life, disability, retirement, and leave-related benefits.</li><li>
Counsels employees on benefit options, eligibility requirements, and coverage provisions.</li><li>
Coordinates and manages the annual open enrollment process, including employee communications and enrollment activities.</li><li>
Processes benefit enrollments, changes, and terminations in a timely and accurate manner.</li><li>
Serves as liaison with insurance brokers, carriers, and third-party administrators to ensure effective service delivery.</li><li>
Arranges on-campus vendor meetings and benefit education sessions for employees.</li><li>
Ensures benefit administration complies with applicable federal and state regulations (e.g., ACA, COBRA, HIPAA, ERISA).</li><li>
Prepares benefit-related reports for internal use and required regulatory reporting.</li><li>
Partners closely with Payroll to ensure accurate benefit deductions, reconciliations, and required reporting.</li><li>
Safeguards the confidentiality and integrity of sensitive employee benefits data in accordance with institutional policy and regulatory requirements.</li><li>
Contributes to employee relations initiatives, including participation in training programs, benefits education, and engagement activities.</li></ul><br>
<p></p><p><br>
Requirements:<br>
</p><ul><li>Bachelor's degree in related field required.</li><li>
PHR, SPHR, SHRM-CP, or SHRM-SCP preferred.</li><li>
Two to four years of related experience preferred.</li><li>
Strong attention to detail with the ability to manage data accurately and prepare reports of a technical nature.</li><li>
Excellent communication, writing, proofreading, and organizational skills.</li><li>
Ability to deliver great customer service while maintaining the decorum of the Human Resource Office.</li><li>
Ability to prioritize multiple tasks and work independently in a fast-paced environment.</li><li>
Intermediate computer proficiency, including HRIS systems, databases, internet applications, email, and Microsoft Office.</li><li>
Demonstrated ability to handle sensitive situations and difficult interactions with professionalism and discretion.</li><li>
Ability to anticipate and plan for cyclical benefits activities (e.g., open enrollment, audits, renewals).</li><li>
Reliability and discretion in handling confidential employee information are essential.</li></ul><br>
<p></p><p><br>
Additional Information:<br>
</p><p>McDaniel College, in compliance with federal and state laws and regulations, does not discriminate in the recruitment, admission, and employment of students, faculty, and staff in the operation of any of its educational programs and activities. McDaniel College will not tolerate any discrimination or harassment on the basis of any protected status including protective hairstyle, race, religion, color, ancestry or national origin, disability, age, sex, gender, gender identity, gender expression, sexual orientation, pregnancy, military status, genetic information, marital status, veteran's status, or any other actual or perceived legally protected characteristics.</p><br>
<p></p><p><br>
Application Instructions:<br>
</p><p>For a complete job description including essential responsibilities and to apply, please visit the college's employment webpage. Completed applications must include a cover letter addressing position qualifications and related experience, resume, and the names and contact information of three professional references. Review of applications will begin immediately. The position will be open until filled.</p></div></div></div></div></div></div></div></div><p></p>

Metropolitan Family Services

<div><p><b>Metropolitan Family Services (MFS) </b>empowers families to learn, to earn, to heal, to thrive. Part mentor, part motivator, part advocate, since 1857, Metropolitan Family Services has been the engine of change that empowers families to reach their greatest potential and positively impact their communities. Are you looking to have an impact on more than just a company&rsquo;s bottom line? Then we&rsquo;d love to hear from you!</p>
<p>
We are now hiring for a full-time <b>Benefit Specialist</b> at our<b> Headquarters</b> office in downtown Chicago!</p><br>
<p></p>
<p><b>
ESSENTIAL DUTIES AND RESPONSIBILITIES:</b></p>
<ul><li>Support day-to-day administration of the agency&rsquo;s benefits programs, ensuring timely and accurate responses to employee inquiries in partnership with the Benefits team.</li>
<li>Identify trends, issues, or gaps in benefits administration and communicate recommendations or changes to improve processes and enhance the overall benefits offering.</li>
<li>Administer leave of absence programs, including FMLA, Short-Term Disability, and Parental Leave, by coordinating requests and tracking through the Prudential system.</li>
<li>Partner with managers and leadership to provide updates on employee leave statuses, timelines, and return-to-work expectations, ensuring clear communication and adherence to policies.</li>
<li>Process and audit benefit enrollments and qualifying life events within the UKG system to ensure accuracy and compliance.</li>
<li>Coordinate and deliver new hire benefits orientations, ensuring employees understand available programs and enrollment processes.</li>
<li>Provide administrative support for Open Enrollment, including system setup, employee communications, and enrollment processing.</li>
<li>Administer COBRA enrollments and eligibility tracking through designated third-party system, ensuring compliance with regulatory requirements.</li>
<li>Identify and resolve benefits carrier and file feed issues by coordinating with brokers, carriers, and third-party administrators.</li>
<li>Review, reconcile, and process benefits invoices across multiple vendors, identifying discrepancies and ensuring timely resolution and payment.</li>
</ul>
<p><b>SALARY: </b>The salary range for this position will be <b>$50,000 - $60,000</b> annually. Pay will be given based on skill and experience level.</p>
<p><b>
REQUIRED EDUCATION, CERTIFICATIONS, CREDENTIALS and/or EXPERIENCE:</b></p>
<ul>
<li>Bachelor&rsquo;s degree in human resources, business or related field required.</li>
<li>2+ year&rsquo;s benefit administration experience.</li></ul><br>
<p></p>
<p><b>
TRAVEL/MOBILITY REQUIREMENTS:</b></p>
<ul>
<li>Driving not required</li>
</ul>
<p><b>TRAVEL BETWEEN SITES:</b></p>
<ul>
<li>Yes</li></ul><br>
<p></p>
<p><b>
PHYSICAL REQUIREMENTS:</b></p>
<p>
While performing the essential duties of this job, the employee is required to sit and stand for sustained periods of time, frequently talk, hear, use hands and fingers to feel, handle, and operate objects or controls, and occasionally stand, bend, stretch, stoop, kneel and crouch. The employee is required to have close visual acuity to perform an activity such as preparing and analyzing data and figures, transcribing, and viewing a computer terminal.</p><br>
<p></p>
<p><b>
Metropolitan Family Services puts our people first with a top-of-the-line benefits package. Find out more by clicking </b><b>here</b><b>!</b></p>
<p><b>
Some highlights include:</b></p>
<ul>
<li>Medical Coverage, Guardian Dental Coverage, and VSP Vision Coverage.</li>
<li>Metropolitan Family Services contributions of $2,000 to individual, and $4,000 to family, HSA accounts, pro-rated to your benefits start date.</li>
<li>FREE General Medicine and Behavioral Health Teladoc services provided to all team members.</li>
<li>Ascensus 401K plan services with a 4% employer match, vested at 100% on day one of eligibility.</li></ul><br>
<p></p>
<p>
And so much more! Make sure you click here to see the full suite of benefits offered!</p><br>
<p></p>
<p><b>
MORE ABOUT US:</b></p>
<p>
Metropolitan is Illinois' first comprehensive human services agency and reaches more than 122,970 individuals and families in Chicago, Evanston/Skokie, the southwest suburbs, and DuPage County with services promoting education, economic stability, emotional wellness, and empowerment.</p></div><p></p>

Benefit Specialist

Herschend Family Entertainment

<div><p><b>ABOUT US</b></p>
<p>
Herschend is the world&rsquo;s largest family-held themed attractions company, with a portfolio of over 40 family entertainment brands across North America, including destinations, resorts, theme parks, water parks, immersive experiences, and content enjoyed by audiences worldwide.</p>
<p>
While each of our family brands offers something unique, all are united by a shared purpose: Bringing Families Closer Together by Creating Memories Worth Repeating&reg;. Our 22,000 passionate hosts make this purpose possible through everyday acts of love and service&mdash;what we call Heartspitality&reg;&mdash;the intersection of heart and hospitality.</p>
<p>
As an equal-opportunity employer, we strive to provide environments where every host, guest, and partner feels welcome, valued, and loved. We firmly believe that words and actions matter, which is why all individuals are to be treated equally and with respect. For more information, visit www.Herschend.com.
</p><p><b>POSITION SUMMARY</b></p>
<p>
With limited supervision, the Benefits Specialist will perform basic benefit administration and administrative office duties.</p>
<p>
This is a Full Time, Hourly Position in our Property Support Center located in Branson, Missouri and reports to the Corporate Benefits Manager.</p>
<p><b>
ESSENTIAL DUTIES &amp; RESPONSIBILITIES</b></p>
<ul>
<li>Manages benefit data within the system(s), collecting payments, tracking and maintaining enrollment data.</li>
<li>Partner with team members and vendors to provide a high level of benefits customer service.</li>
<li>Monitor and ensure Hosts are working per their classification through follow-up and proper reporting. Make recommendations regarding Host classification changes.</li>
<li>Ensures data integrity between systems and vendors.</li>
<li>Investigate discrepancies and provide information in nonroutine situations.</li>
<li>Evaluate internal processes to increase efficiency.</li>
<li>Assist in preparation of deduction/contribution reports for each payroll.</li>
<li>Coordinates workflow between Corporate Benefits and other HR/Benefit departments.</li>
<li>Maintain benefits records.</li>
<li>As requested, assist with special projects such as annual enrollment, ACA/1095Cs and ensure that all necessary deadlines are met.</li>
<li>Ensure compliance with applicable government regulations (ERISA, ACA, FMLA, COBRA, Section 125, and HIPAA) and Company policies.</li>
<li>General office duties such as working at the reception desk, correspondence, filing, and answering employee inquiries.</li></ul><br>
<p></p>
<p><b>
EXPERIENCE &amp; EDUCATION</b></p>
<ul>
<li>Minimum of three years of data processing/computer experience. Previous benefits/HR experience strongly preferred.</li>
<li>Proficient in Microsoft Word, Excel and PowerPoint. Experience with UKG/UltiPro systems preferred.</li></ul><br>
<p></p>
<p><b>
SKILLS &amp; QUALIFICATIONS</b></p>
<ul>
<li>Strong communication skills, oral and written and exceptional organizational skills.</li>
<li>Must handle confidential information responsibly and exercise good judgment regarding privileged information.</li>
<li>Must be able to work in ambiguous environments and demonstrate ability to work independently.</li>
<li>Flexibility and ability to deal with changing priorities.</li>
<li>Proven ability to work effectively in a team environment.</li>
<li>Must be able to type 40</li>
<li>Excellent organization, multitasking, prioritizing, and filing</li>
<li>Ability to compose routine business correspondence, memorandums, spreadsheets, forms, etc.</li>
<li>Must be detailed and customer service oriented.</li></ul></div><p></p>

RetireeFirst

<div><div>LaborFirst is the leader in Care Navigation and advocacy, dedicated to improving outcomes and satisfaction for group plan sponsors and their members. Founded in 2005, we partner with all major national health carriers to serve 450+ clients and over 375,000 Medical and Pharmacy lives across all 50 states. We deliver high-touch solutions that drive value while preserving benefits. RetireeFirst, a LaborFirst solution, provides end-to-end Retiree Benefits Management. In partnership with plan sponsors, brokers, and consultants, we design, implement, manage, and administer Medicare benefits, ensuring a seamless transition and continued support. HealthActive, our solution for self-insured health plans with actives and early retirees, combines one-on-one health advocacy with technology-driven insights to help members successfully navigate their healthcare journey.<br>
</div>
<div></div><div>Summary of Position:</div>
<div>Provide High Level Customer Service to all Participating Members. Reports to the Client Service Managers and the Client Service Director to assist with team responsibilities.</div>
<div></div>
<div>Duties &amp; Responsibilities:</div>
<div></div>
<ul><li> Fully versed in assisting members with any issues/concerns.</li></ul>
<ul><li> Assist Team Leads with Projects/Eligibility/Billing.</li></ul>
<ul><li> Answer member phone calls.</li></ul>
<ul><li> Handle member plan selections.</li></ul>
<ul><li> Attend Team/Division Meetings.</li></ul>
<ul><li> Able to handle most retiree calls with little to no support from management.</li></ul>
<ul><li> Fully versed in all our products, processes, and procedures.</li></ul><div>
Licensing &amp; Qualifications:</div>
<ul><li> High School Diploma or Equivalent</li></ul>
<div></div>
<div>Preferred Qualifications:</div>
<ul><li> Life and Health License</li></ul>
<ul><li> AHIP Training and Certificate</li></ul>
<ul><li> 1+ Year Customer Service Experience</li></ul><p></p><div><br>
LaborFirst is committed to regulatory excellence and operational integrity. We have attained HITRUST r2 certification for our Box and Salesforce platforms and hold full URAC Core Accreditation. With headquarters in Mount Laurel, NJ, and our LaborFirst West facility in Scottsdale, AZ, our award-winning team and services have earned national recognition. We consistently achieve world-class Net Promoter Scores (NPS), have been named on the <i>Philadelphia Business Journal</i>&rsquo;s Best Places to Work list, and have received multiple industry accolades, including a 2024 and 2025 Gold Stevie Award for Front-Line Customer Service Team of the Year. Connect with us at LaborFirst.com.</div><br>
<p></p>
<p>
Competitive salary</p>
<p>
Comprehensive benefits package</p>
<p>
401k contribution</p>
<p>
Generous vacation time</p>
<p>
Opportunity to grow</p>
<p>
Fastest 50 Growing Companies in NJ</p>
<p>
Must be excluded from OIG/SAM</p><br>
<p></p>
<p>
All qualified applicants will receive consideration for employment without regard to race, age, color, ancestry, national origin, place of birth, religion, sex, sexual orientation, gender identity and expression, military or veteran status, genetic characteristics, or disability unrelated to job performance.</p></div>

Volunteers of America- Greater New York, Inc.

Volunteers of America–Greater New York (VOA–Greater New York) is a leading anti-poverty organization serving neighbors in need across New York City, Northern New Jersey, and Westchester. Through 70+ programs, we support over 35,000 adults and children each year, including individuals experiencing homelessness, survivors of domestic violence, youth aging out of foster care, veterans, seniors, and children with developmental delays.
<br>Our staff are at the heart of this work, creating meaningful change every day. If you’re passionate about making a difference and joining a mission-driven team, we invite you to explore this opportunity.
<br>We are currently seeking qualified candidates for the following position:
<br><br>
<b>Position:</b> Benefits Specialist
<br><br>
The Benefits Specialist offers support to eligible formerly homeless clients living in Permanent Supportive Housing to promote well-being and stability. The Benefits Specialist is part of a specialized team working across four SRO sites in The Bronx and Brooklyn. The Benefits Specialist will be assigned a caseload of clients at one of those sites and will coordinate closely with case management, recreational and operations staff at the building to which they are assigned
<br><br>
East 119th Street Veterans Residence is a single room occupancy (SRO) residence that provides permanent, supportive housing to formerly homeless single veteran men and women, including those diagnosed with a mental illness. To learn more about the program, copy and paste this link into a browser https://www.voa-gny.org/our-vets-programs
<br><br>
<b>Location:</b> New York, NY 10036
<br><br>
<b>Minimum Qualifications:</b><br>
<ul>
<li>Associate's degree or 60 college credits courses in Human Services field or High School Diploma or GED with 2 years of related experience helping low-income clients access and maintain benefits including Public Assistance, Disability and Veterans benefits.</li>
<li>The position also requires a demonstrated ability in verbal and written communication, including basic computer skills.</li>
</ul>
<b>Benefits Specialist Principal Responsibilities:</b><br>
1. Conduct benefits assessments and provide individualized education, assistance, referrals and advocacy to help clients obtain and retain any and all benefits to which they are entitled, including accompanying clients to appointments as needed.
<br>2. Work with clients and their medical and behavioral health providers to document disability to support SSI/SSD applications and appeals.
<br>3. Provide individualized money management and budgeting coaching and as needed connect clients to services to adult guardianship or representative payee services.
<br>4. Develop and deliver workshops on topics related to benefits, budgets and money management.
<br>5. Utilize best practice approaches and evidence-based interventions to maximize client outcomes.
<br>6. Maintain service documentation to include client progress notes, observations and interactions about clients and incident reporting when necessary.
<br>7. Participate in internal and external case conferencing activities.
<br><br>
We are committed to offering our employees an exceptional comprehensive benefits package that supports their health, well-being, and personal growth. Full-time employees enjoy:
<br><br>
<ul>
<li>Medical, Dental, & Vision Coverage</li>
<li>Prescription Coverage</li>
<li>Life Insurance</li>
<li>Retirement Plan</li>
<li>Tuition Reimbursement</li>
<li>Paid Time Off, including a Paid Birthday Holiday</li>
</ul>
And much more!
<br><br>
To learn more about our staff, culture and much more, copy and paste our website link into a browser: https://www.voa-gny.org/our-staff-and-culture/
<br>VOA-Greater New York is an Equal Opportunity Employer/Vets/Disabled/Other Protected Categories. Apply today!

Benefits Specialist/Case Manager

Beacon Health System

<div><div><div><div><div><div><p>Beacon Health System is hiring <b>a full-time day Patient Access Insurance </b><b>Specialist</b>, in our <b>Verification of Benefits</b> <b>Department</b> at <b>Beacon Health System</b> in South Bend, IN.<br>
<br>
<b>Be a Beacon. Make a Difference.</b></p>
<p>At Beacon Health System, you&rsquo;re not just part of a team, you&rsquo;re part of something bigger. Every patient interaction is a chance to lead with compassion, build trust, and create lasting impact. Here, your expertise supports healing, and your heart connects us to the communities we serve.</p>
<ul><li>Medical, Dental, &amp; Vision Insurance through Cigna</li>
</ul><ul><li>Life Insurance</li>
</ul><ul><li>403(b) Matching Retirement Fund</li>
</ul><ul><li>Competitive Paid Time Off (PTO)</li>
</ul><ul><li>Shift Differentials</li>
</ul><ul><li>Employee Assistance Program (EAP)</li>
</ul><ul><li>Tuition and Certification Reimbursement</li>
</ul><ul><li>Clinical Ladder Program</li>
</ul><ul><li>Local and National Discounts</li>
</ul><ul><li>Beacon Academy Educational Courses</li>
</ul><ul><li>Gym Membership Discount</li>
</ul>
<p><b>About Beacon Health System</b></p>
<p>Headquartered in South Bend, Indiana, as a not-for-profit, community-governed health system, Beacon Health System provides care to more than 4,000 patients each day in northern Indiana and southern Michigan.</p>
<p><b>What You&rsquo;ll Do</b></p>
<p>As a Patient Access Insurance Specialist, you will report to the Patient Access Director or the Insurance Specialist Supervisor. Follows established Beacon policies and procedures to verify insurance coverage to ensure necessary procedures and hospitalizations are covered by an individual's provider. The Insurance Verification Authorization Specialist will assure authorization is obtained for all procedures and diagnostic testing to services being rendered. The Authorization Specialist will also initiate the authorization for direct admissions, emergency admissions, and emergency procedures. They will work closely with medical staff, clinical staff, referring clinics, Beacon Outpatient Scheduling Surgery Scheduling, Social Services, and Utilization Review departments. They will be responsible for communication with insurance carriers and/or providers for purposes of obtaining approval for services requiring authorization, pre-certification, and prior approval for admissions to Beacon or Epworth Center by using web-based tools, other electronic means where possible, or by telephoning and faxing when necessary. Coordinating those visits with the correct paperwork and insurance verification, along with accurate documentation in the patient's medical record is essential. They will answer high volume of incoming phone calls as well as making high volume of outbound phone calls, with constant communication to the Utilization Review, Social Services, Beacon Outpatient Scheduling and Surgery Scheduling departments. Performs other clerical duties as necessary.</p>
<p><b>Patient Access Insurance Specialist</b> <b>Job Responsibilities:</b></p>
<ul><li>Verify and update patient demographic and financial information to ensure accuracy in the registration system.</li>
<li>Obtain and validate insurance coverage using online eligibility systems, payer portals, and telephone verification.</li>
<li>Utilize Cerner systems and reports (e.g., PHS, SurgiNet, Medical Necessity Checker) to review scheduled patients, procedures, and medical necessity requirements.</li>
<li>Audit and complete required documentation, including MSP questionnaires and insurance verification records.</li>
<li>Coordinate verification of benefits (VOB) by confirming co-pays, deductibles, coinsurance, out-of-pocket limits, and rehabilitation benefits with insurance providers.</li>
<li>Secure and document pre-authorizations and pre-certifications for ancillary, surgical, outpatient, and inpatient procedures.</li>
<li>Collaborate with physician offices, scheduling teams, and referring facilities to ensure required authorizations are obtained and procedures are properly scheduled.</li>
<li>Validate CPT and ICD-10 codes and confirm compliance with Medicare Inpatient Only Procedure (MIPO) requirements when applicable.</li>
<li>Identify out-of-network insurance plans and follow established policies and procedures.</li>
<li>Refer patients to Financial Counselors or Eligibility Specialists when financial clearance or payment arrangements are required.</li>
<li>Maintain accurate worklists, documentation, and records to support timely claim submission and reimbursement.</li>
<li>Calculate and communicate estimated patient financial responsibility, including co-payments and coinsurance.</li>
<li>Prepare reports, patient statistics, and documentation to support departmental operations and leadership requests.</li>
<li>Provide professional customer service by answering calls, communicating with patients and internal departments, and maintaining positive patient relations.</li>
<li>Collaborate with departments such as Utilization Review, Surgery Scheduling, Social Services, and Outpatient Scheduling to ensure accurate and timely patient processing.</li>
<li>Support departmental quality goals by maintaining productivity, accuracy, and compliance with Beacon policies and procedures.</li>
<li>Maintain professionalism while representing Beacon Health System and perform other duties as assigned.</li>
</ul>
<p><b>What You Bring</b></p>
<p>As a Patient Access Insurance Specialist, it requires strong office and computer skills, including keyboarding (minimum 40 wpm), data entry, and proficiency with systems such as Cerner, Pathways Healthcare Scheduling, Experian, and MCA Compliance Checker. Demonstrates knowledge of medical terminology, insurance coverage, managed care networks, ICD-10 and CPT codes, and time-of-service collections, including the ability to clearly communicate financial responsibilities to patients. You will possess strong telephone, verbal communication, and listening skills to effectively interact with patients, insurance companies, physicians, and internal departments. You will maintains professionalism and sensitivity when working with diverse populations, follows strict confidentiality policies, exercises sound judgment in stressful situations, and applies basic math skills to calculate patient financial responsibilities such as deductibles, coinsurance, and out-of-pocket costs.</p>
<p><b>Required Qualifications</b></p>
<ul><li>The knowledge, skills and abilities as indicated below are normally acquired through the successful completion of a high school diploma (or equivalent).
</li><li>A minimum of two years of experience in a hospital or physician practice business office is required.
</li><li>Excellent time management, organizational skills, research/analytical skills, negotiation, communication (written and verbal), and interpersonal skills required.</li>
<li>A medical terminology course must be successfully completed prior to employment.
</li><li>Associate's degree preferred.
</li><li>Medical prior authorizations or claims experience in a managed care setting and CHAA certification are highly preferred.</li>
</ul>
<p><b>The Beacon Way</b></p>
<p>At Beacon Health System, our approach to care goes beyond clinical excellence because it&rsquo;s built on meaningful connections. Guided by our core values of Trust, Respect, Integrity, and Compassion, we strive to create an environment where patients feel heard, employees feel valued, and innovation thrives.</p>
<p>We call this commitment The Beacon Way&mdash;a six-point operating system that empowers every team member to lead with purpose, communicate clearly, cultivate talent, embrace performance improvement, leverage innovation, and build greatness through accountability. Whether at the bedside or behind the scenes, everyone at Beacon plays a role in moving health forward.</p></div><br>
</div>
</div></div></div><br>
Location: Beacon Health System &middot; Verification of Benefits<br>
Schedule: Full-time, Day, 0830-5pm M-F</div>

Patient Access Insurance Specialist, Verification of Benefits Department, Full-Time Days

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Patient Access Insurance Specialist, Verification of Benefits Department, Full-Time Days