100% onsite
Must have prior authorization/verification experience.
Job Duties:
- Contacts insurance companies to verify insurance benefits.
- Initiates Pre-authorization, PCP referral, and Letter of Agreement requests for new and ongoing services with insurance companies and performs follow up activities for an outcome.
- Files Appeals for denied coverage to insurance companies as needed.
- Maintains customer records in practice management system related to benefit coverage, coordination of benefits, authorizations, denials, appeals, outcomes and communication with insurance company.
- Coordinates and communicates with other departments as needed to obtain necessary information to complete benefit verification, authorization, appeals and outcomes for services of care.
- Provides customers with information that includes but is not limited to: updates on status of authorizations, developing & communicating patient financial responsibility estimates, and collecting co-pays, if applicable.
- Applies knowledge of company procedures, contracted and non-contracted guidelines to process cases accordingly and to respond to incoming correspondence and documentation as well as updating customer records according to outcomes.
- Performs other related duties as assigned.
Skills:
- Understanding of Medicare rules and regulations
- Understanding of managed care as it relates to benefits and authorizations
- Advanced MS Office experience
- Strong verbal and written communication skills
- Must have prior authorization/verification experience.
- Preferred two or more years' experience, but a minimum of 1 year experience is required in insurance benefits verification and/or collections and/or managed care contracting.
- Excellent verbal and written communication skills, including ability to effectively communicate with internal and external customers.
- Must be able to work under pressure and meet deadlines
Education:
- Min. HS diploma or GED equivalent