Eligibility and Benefits Specialist - Philippines
Philippines
Customer Success – Eligibility and Benefits /
Consultant/Contractor /
Remote
FORTA’S MISSION:
Forta is clearing the path to quality healthcare by delivering the best possible outcomes with the utmost convenience. 1 in 36 children [CDC, 2023] is diagnosed to be on the autism spectrum. Currently, autism support via Applied Behavior Analysis (ABA) is difficult to access and the delivery model must be expanded to provide earlier access to families.
Forta is not only providing ABA services to our clients, but we’re also improving the future of the ABA experience for families by creating software and predictive algorithms that elevate clinicians to work smarter by surfacing the latest and most relevant case data. We are working diligently to continuously improve the patient journey and deliver personalized care by applying smart technology and investing in the growth of our world-class team.
Outcomes:
- Obtain precise eligibility and benefits details from clients' insurance carriers.
- Determine billable status and provide an estimate of patient responsibility for ABA services.
- Ensure the E&B report template contains factual and error-free data.
- Clearly explain any nuanced details to make the data comprehensible for both internal teams and client families.
- Complete and deliver the benefits report within 24 hours of receiving a request.
- Upload E&B Form for cross-departmental access.
- Send and process signed Benefits Acknowledgements.
- Follow up with parents on any unsigned Benefits Acknowledgements.
- Proactively coordinate with parents to collect and update insurance information as needed.
- Assist with ad-hoc projects and administrative responsibilities.
Competencies:
- Familiarity with insurance billing systems and ability to quickly adapt to Forta’s industry terminology.
- Experience in medical billing
- Exceptional written and verbal skills, including the ability to clearly ask questions and gather concrete answers.
- Fluent in English with clear enunciation for navigating automated phone menus.
- Ability to accurately take detailed notes during calls.
- Respect for patient privacy and commitment to following HIPAA protocols.
- Maintain documentation quality and ensure data integrity.
- Demonstrate role-based competencies aligned with our cultural values: Customer Obsession, Bias for Effective Action, Extreme Ownership, and Stay Curious.
- Maintain a professional demeanor during long hold times and through complex call transfers.
- Demonstrate resilience and adaptability in high-pressure situations.
- Uphold an entrepreneurial mindset and a focus on continuous improvement.
- Proficient with Google Suite, Microsoft Office, and CRM systems.
Requirements:
- Bachelor's Degree or equivalent work experience
- Human Services, Social Work, Public Health
- Reliable personal computer or laptop with minimum specifications 5 - 10 Gen with at least 8GB DDR4 RAM or equivalent
- Reliable internet connection with minimum 50 Mbps subscription speed and back-up ISP
- Availability to work an 8-hour shift between 9 AM to 5 PM EST, CST, or PST
₱281 - ₱394 an hour
Apply Today!
We are looking for you! A driven, innovative, client-focused individual to join our team as we innovate the care and tools available to neuro-diverse families. If this position sounds like the opportunity you have been searching for, we want to speak with you!
We look forward to working with you!
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All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status. Forta is a Drug-Free Workplace/ EO employer – M/F/Veteran/Disability.
