INSURANCE VERIFICATION REPS 4 NEW OPENINGS TODAY!
OPTION 1 STAFFING'S NON- CLINICAL MEDICAL DIVISION is currently looking for 4 sharp medical insurance verification reps And must have 6 mos to a year experience.
The Patient Financial Clearance Representative, under direct supervision of the Payor Authorization Coordinator, performs specialized functions for patients by completing all activities related to insurance verification and securing authorization
The essential functions listed are typical examples of work performed by positions in this job classification. They are not designed to contain or be interpreted as a comprehensive inventory of all duties, tasks, and responsibilities. Employees may also perform other duties as assigned.
• Completes insurance verification, eligibility and benefit determination process utilizing integrated electronic eligibility system, payer websites, and phone for all insurance plans within the scope of the patient financial clearance department and assigned service line.
• Interprets and documents the appropriate co-pay, deductible, share of cost, co-insurance, maximum benefit levels and/or available days.
• Contacts patient as appropriate to obtain correct and updated information when necessary
• Completes Medicare Secondary Questionnaire as appropriate.
• Applies authorization rules and requirements for all payors within the assigned work queues.
• Develops a strong working knowledge of the procedures and diagnosis used in the assigned service-lines to ensure authorizations are properly completed for the scope of services that will be rendered to the patient.
• Assesses the data required for authorization and securing sponsorship. Communicates with respective clinics and referring providers to secure appropriate information to complete an authorization.
• Follows up on pending authorization and referral requests to ensure timely completion and secured sponsorship for cases in the assigned work queue.
• Arranges escalation process for clinics and clinicians to complete peer-to-peer appeal reviews with payor utilization management when needed.
• Prioritizes work assigned to ensure that financial risk is minimized and timely completion of authorizations is optimized.
Any combination of education and experience that would likely provide the required knowledge, skills and abilities as well as possession of any required licenses or certifications is qualifying.
• High School diploma or GED equivalent
• Two (2) years working knowledge of patient registration and insurance verification and authorization processes in a medical organization.
• Any combination of education and experience that would likely provide the required knowledge, skills and abilities as well as possession of any required licenses or certifications is qualifying.
Knowledge, Skills, and Abilities
• Intermediate and advance knowledge of Microsoft applications (Word, Excel, etc.)
• Demonstrated communication, customer relations, and organizational skills
• Ability to multi-task with attention to detail
• Ability to complete work efficiently and problem solve independently
• Ability to work in a team.
For immediate consideration please apply.