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Medical Insurance Specialist - Claims Analyst

Music City Prep Clinic Nashville ,TN
  • Posted: over a month ago
  • Full-Time
  • Benefits: vision, 401k, dental, life_insurance, medical
Job Description

 

At Music City PrEP Clinic, we are passionate about changing the face of healthcare in Nashville by providing access to biomedical interventions and services for sexual health and wellness. We are LGBTQ friendly and serve our patients with a highly skilled, competent team of clinicians, staff and volunteers who dedicate their time and expertise to see patients during convenient weekday and weekend hours. We accept insured and uninsured patients with affordable, low-cost or no cost services.


The Insurance Specialist ensures that patients receive their medications promptly and affordably.


Duties and responsibilities

  • Ensure patients receive their medications promptly and affordably by:

    • Verifying correct insurance information was sent to Avita.

    • Communicating with Avita or secondary pharmacy that Rx was written and sent over.

    • Quickly responding to any inquiries from Avita regarding Rx that would delay processing.

    • Communicating with pharmacies to ensure timely processing of insurance and PAP payments

    • Investigating and mitigating any insurance denials or prior authorizations

    • Recording insurance and PAP payments to Music City PrEP Insurance Verification database

    • Assisting uninsured patients with Prescription Assistance Program.

    • Communicating with insurance companies, pharmacies, providers, and health departments as needed.

    • Communicating with patients with whom insurance may have changed and communicate back to Avita the updated insurance information.

  • Responds to messages in personal Athena inbox in a timely manner. 

  • Communicates with patients clearly, effectively with empathy, integrity, and accuracy.

  • Accurately reports hours worked in ADP app and keep your supervisor informed of any deviations of your normal work schedule.

  • Completes special projects as assigned by supervisors.



 

Qualifications

 

  • Must work effectively with physicians, staff, volunteers, patients, public and external agencies

  • Skills in gathering and interpreting data in a physician office setting

  • Must have the ability to take initiative and to exercise independent judgment, 

  • Must have working knowledge of all navigation departments and tools necessary to perform the navigation roles. 

  • Possess decision-making and problem solving expertise.

  • Understands all of the functions of the office navigation process and has the ability to perform each navigation job as needed.

  • Must remain receptive to changing responsibilities and maintain a high level of confidentiality and privacy according to the clinic’s policies and procedures and HIPAA compliance. 

 

Company Description
Founded in 2017, the Rod Bragg Music City PrEP Clinic is a sexual health and wellness clinic. Our mission is to get to zero new HIV transmissions in Nashville and middle Tennessee. We do this by providing affordable sexual wellness and healthcare. We provide discreet no-cost HIV screens,STD/STI testing and treatment. If appropriate, we'll provide patients with a prescription for PrEP (Truvada or Descovy). If someone is unable to afford the medication, we'll work to help them cover the costs. We accept patients who are insured, under-insured, and uninsured. We are in search of a part-time contract Physician to join our team of providers in one of Nashville's fastest growing and most dynamic healthcare clinics.

For more information, please visit www.musiccityprep.org​.

Music City Prep Clinic

Why Work Here?

Flexible work schedule, competitive pay, very non-traditional work environment

Founded in 2017, the Rod Bragg Music City PrEP Clinic is a sexual health and wellness clinic. Our mission is to get to zero new HIV transmissions in Nashville and middle Tennessee. We do this by providing affordable sexual wellness and healthcare. We provide discreet no-cost HIV screens,STD/STI testing and treatment. If appropriate, we'll provide patients with a prescription for PrEP (Truvada or Descovy). If someone is unable to afford the medication, we'll work to help them cover the costs. We accept patients who are insured, under-insured, and uninsured. We are in search of a part-time contract Physician to join our team of providers in one of Nashville's fastest growing and most dynamic healthcare clinics. For more information, please visit www.musiccityprep.org​.

Address

Nashville, TN
USA

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