The Medical Insurance Verification & Authorization Specialist is responsible for the following:
· Obtains authorization from payer's case manager for services ordered/requested for prospects/ referrals in a timely manner.
· Documents specific details related to the authorization including effective and end dates using the appropriate legacy system and associated software application via patient notes, authorizations, tasks, workflow, phone calls and/or email.
· Serves as a liaison between the branch locations and the payer on a regular basis.
· Coordinates and communicates with the branch locations regarding any changes or updates from the payer in a timely manner.
· Accesses authorizations via email, telephone, fax, and/or on-line application in the most efficient and timely manner.
· Resolves all customer requests, inquiries, and concerns in an expedient and respectful manner.
· Problem solves independently before referring issues to the Supervisor/Manager for resolution.
· Performs eligibility and benefit verification for all new and existing patients.
· Provides and serves as backup support for the Front Desk/Scheduling Coordinator.
• High School Diploma Or equivalent.
• Must have experience working with insurance companies, and have extensive knowledge of different types of coverage and policies.
• Must possess exceptional time management, communication and telephone skills.
• Must have intermediate computer knowledge and ability to work in the outpatient registration system, Excel and Microsoft Word.
• Prior Medical Insurance Verification Experience Required.
• Medical billing experience preferred.