New 
Verification of Benefits Specialist
 Spectraforce Technologies | |
 United States, Texas, Plano | |
| 1201 West 15th Street (Show on map) | |
 Aug 26, 2026 | |
| Verification of Benefits Specialist 6600 Pinecrest Plano, Texas -100 percent onsite Days/Hours: Mon - Friday 8:00am-5:00 PM Selected Candidate will start ASAP after screenings have cleared. Our location in Plano, TX currently has an opportunity for a Patient Therapy Access Specialist (PTA). As a PTA Specialist you are responsible for facilitating and assisting Abbott patients with the pre-certification, pre-determination and authorization process necessary as a prerequisite to perform various procedures or forms of therapy based on physician recommendation. WHAT YOU'LL DO Assist with multiple levels of appeal in the event of initial coverage denial. Forward authorized confirmation for procedure to designated patient provider. In addition, this position will provide in-servicing to new patient providers surrounding the pre-authorization process. Responsible for managing multiple cases simultaneously within specific time frames Follow all policies and procedures related to performing the job role adhering to all data use, storage and privacy policies as outlined by Abbott Verify benefits, complete authorization requests promptly Timely follow up for requested authorizations For each procedure, audit required clinical documents for completeness and accuracy Obtain authorization for the facility, equipment and physician to perform various procedures from the insurance carrier Work with key provider contacts to obtain required clinical information for authorizations Work with respective carrier's utilization review department to obtain appropriate authorizations Work within established guidelines when necessary to process appeal for denied requests Train patients and their designated providers on pre-authorization processes and requirements, in person or by phone Work individually and in a team environment to educate assigned Field Territory Managers and Clinical Specialists EDUCATION AND EXPERIENCE YOU'LL BRING Required Associate degree in Nursing/Home Health (LVN/LPN) or related field required. Minimum of 2 plus yrs experience in a utilization (medical approval) environment or similar work experience Preferred Knowledge of private insurance, Worker's Compensation and Medicare guidelines pertaining to Prospective and Retrospective Utilization Review. Experience in medical device or DME Billing a plus Proficient with Microsoft Office (Word & Excel specifically) Medical billing software experience a plus Knowledge of current CPT codes and familiarity with ICD-10CM (diagnosis coding) Ability to accurately meet required time frames/deadlines Ability to work as a team player and share workloads with other team members Excellent verbal and written communication skills Ability to train/present concepts to others Enable Skills-Based Hiring No Start Time (AM/PM) 8:00 AMEnd Time (AM/PM) 5:00 PMCategory HealthcareDate of Manager Spotlight Call or Exception Reason N/A Repeat Role | |