VERIFIFCATON of BENEFITS (VOB) SPECIALIST

SUMMARY:  

Responsible for verifying insurance coverage, supporting Medicaid eligibility processes, and maintaining accurate documentation in the EHR. Collaborates with admissions, clinical, and billing teams to ensure accurate payer setup. Provides guidance to clients but does not determine eligibility or submit applications without consent.

PRIMARY RESPONSIBILITIES 

• Monitor admissions and scheduling using Teams and InSync reports
• Maintain accurate client demographics and resolve discrepancies
• Verify Medicaid, Medicare, commercial, and out-of-state insurance
• Collect and upload insurance documentation and submit vendor requests
• Verify NM Medicaid and assist clients when coverage is inactive
• Maintain accurate payer hierarchy, including BHSD coverage
• Review and correct coordination of benefits issues
• Perform ongoing monthly coverage verification and documentation 

MINIMUM QUALIFICATIONS 

• High school diploma required; higher education preferred
• 1–3 years healthcare insurance verification  
• Knowledge of Medicaid, Medicare, and commercial insurance
• EHR experience preferred (InSync a plus)
• Strong organizational and communication skills 

CORE COMPENTENCIES 

• Attention to Detail 
• Time Management  
• Communication  
• Problem Solving  
• Teamwork