Insurance Authorization Jobs in Remote, OR (NOW HIRING)

WHO WE ARE:

Aviva Health is a dynamic and mission-driven federally qualified health center (FQHC). Committed to providing comprehensive and compassionate healthcare services, Aviva Health offers a holistic approach to care, addressing patients' medical, behavioral health, dental, and social service needs. As a vital healthcare resource in the community, Aviva Health fosters a collaborative and supportive work environment where dedicated healthcare professionals have the opportunity to make a meaningful impact on the lives of individuals and families. Join us at Aviva Health and be part of a team that is dedicated to making a difference in the lives of our patients and the community we serve.

BENFITS INCLUDED:

• Monday - Friday Scheduling
• Paid Holidays
• PTO
• Comprehensive Medical, Dental, and Vision Coverage
• 403(b) Retirement with Employer Match

POSITION PURPOSE:

Under the supervision of the Patient Services Rep Supervisor or FM Clinic Manager, the Patient Services Representative II (PSR II) Float utilizes established procedures to ensure efficient and effective flow of patients through joint planning and problem solving with clinic staff and volunteers.

ESSENTIAL FUNCTIONS:

• Register patients at the time of appointment; complete all necessary paperwork; assist patients with paperwork to ensure completion as needed.
• Screen new patients for eligibility, collect all financial and demographic information and prepare patients chart. Photocopy insurance or other third-party payer information.
• Prepare patient charts for appointments and verify demographics and financial information including verifying continued eligibility with patients upon checking in. Update patient charts and computer files.
• Answer all telephone calls courteously, take messages or transfer calls to appropriate person and regularly communicate with patients on hold so that they do not feel ignored.
• Schedule patient visits.
• Calculate individual patient charges for services; collect payment and/or explain payment process.
• Record receipt of fees in practice management system.
• Complete assigned typing, including clinic letters and forms as requested.
• Perform a wide range of general office procedures necessary to ensure the smooth operation of the clinic.
• Attend in-services and other required meetings.
• Follow all Aviva Health policies and procedures.
• Work at different clinics daily, weekly and monthly.
• Is prepared to begin each shift at the designated location at the scheduled time, meet attendance standards and work the hours necessary to perform the essential functions of the job.
• Scrub patient charts and work on Gap List.
• Medical Referral duties: determine where to refer if the provider has not indicated a specific provider; make patient appointments with specialist, fax all pertinent chart information, determine patient payment, and contact if appointment chart notes and documentation are not received as needed; communicate with patient regarding information required for patients referral appointment; notify provider of any pre-authorization denials, review and provide guidance regarding supporting documentation that may be required for approval, and refer the patient back to their primary care provider for further instruction; process medication pre-authorizations; process insurance referral authorization requests from external facilities.
• Call center duties: Answer telephone, register new patients, update demographic information in EMR, schedule and review appointment information with patient; remind patient when to arrive, what to bring to appointment and of cancellation/no-show policy, and answer any questions. Screen new patients for eligibility, collect financial information, take insurance or other third-party payer information, and prepare chart.
• Medical Records Duties: Pull patient charts, perform patient correspondence and notification of test results, process medical records requests within established timeframe, follow medical records release procedure. Log requests in patients chart.
  

PROFESSIONAL QUALITIES:

• Display a high level of initiative, effort, and commitment to completing assignments efficiently and timely. Work with minimal supervision and exercise sound judgment and attention to detail.
• Conform to safety work ethics, be flexible and show dedication to the position and community.
• Promote positive customer relations and service to both internal and external customers in a non-discriminatory, confidential, professional, and friendly manner that builds dignity for each individual person.

QUALIFICATIONS:

• High school graduate or equivalent education.
• Must possess knowledge of Practice Management and Electronic Medical Records.
• Knowledge of collection procedures and laws preferred.
• Must be able to type 40 wpm and operate a 10-key adding machine by touch.
• One (1) year clerical experience in a front facing position required.
• One (1) year clerical experience in a clinical or health care position preferred.
• Familiarity with medical terminology and anatomy and knowledge of office practices and procedures.
• Ability to be cross trained in Specialties, Family Medicine, and Pediatrics duties.
• Ability to be flexible and retain special training in call center, Medical Records, insurance coordination, medical referrals, Gap List, and chart scrubbing.

Aviva Health is an Equal Opportunity Employer
We are committed to fostering a diverse and inclusive workplace where all qualified applicants receive consideration for employment without regard to race, color, religion, gender, gender identity, sexual orientation, national origin, age, disability, veteran status, or any other legally protected status.

Aviva Health is a Drug-Free Workplace

To ensure a safe and secure environment for our employees and patients, Aviva Health maintains a drug-free workplace. All employment offers are contingent upon passing a drug screening and a criminal background check. Compliance with these policies is required throughout employment.