Retina Verification Specialist

Retina Verification Specialist

Job description

Summary:
The Retina Verification Specialist is responsible for ensuring that authorizations and referrals for retina medications are properly obtained prior to the patients arriving for their appointment and that all scheduled appointments are screened three weeks ahead of the schedule.

Minimum Qualifications:
Education & Experience
- High School Diploma or equivalent required
- Insurance verification experience preferred

Essential Skills and Abilities:

- Proficient computer skills
- Proficient phone skills
- Detail Oriented
- Ability to problem solve
- Ability to work in a fast-paced environment while maintaining accuracy

- Ability to work well in a team environment
- Self-directed, highly motivated, and ability to multi-task
- Excellent communication skills, proper grammar and writing capability
- Possess a caring, patient, and friendly attitude
- Excellent organizational skills

- Knowledge of or ability to learn understanding of ophthalmic diseases, terms and spelling of same

Duties:
- Screen the appointment list of patients three weeks before visit and review each individual account
- Verify if we have a referral or authorization already one file or if a new request needs to be created for the medication being ordered and administered
- Keep a running electronic log of what has been requested and following up on the requests if the referral or authorizations have not been received by using shared document in Microsoft applications
- Communication with the primary care physicians, other specialists’ providers, and insurance company in a pleasant and expeditious manner for any referral or authorization requests and/or troubleshooting
- Properly documents authorization details in the patient’s alert section of the medical record and in log of Microsoft application by following proper documentation requirements
- Verify eligibility of applicants by completing required forms, phone calls, or face-to-face interviews
- Verifies whether the plan coverage is Primary or Secondary; HMO, PPO or Commercial Carrier Insurance
- Verifies the status of deductible and requirements of various co-pays or out-of-network requirements

- Knowledge of or ability to learn complete understanding of Medicare, Medicaid, HMO and commercial insurance plans and eligibility requirements
- Knowledge of or ability to learn complete understanding of all forms (paper & electronic) associated with the patient’s medical record
- Knowledge of or ability to learn complete understanding of ICD-9/10 and CPT Coding for Ophthalmology
- Other duties as assigned

Physical Requirements:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
- The majority of the time on-the-job is spent sitting and walking
- At times, the job may require some lifting up to 50 pounds
- This job requires the following types of vision: close, distance, peripheral and depth perception
- Must be able to communicate clearly in person and over the telephone and in email
- Hearing must be adequate to perform job duties in person and over the telephone
- Typical noise level for the work environment of this job is moderate (i.e. clinical office with phones, computers, printers, testing equipment, patient waiting areas)
- Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions

Other:
- This job description is intended only to describe the general nature and level of work performed and should not be interpreted as an exhaustive list of all duties, skills, and responsibilities.
- A valid Florida driver’s license and reliable transportation is required as this position may be required to travel to various satellite locations as needed for work assignments.
 

Job Type: Full-time
 

Expected Hours: 40 per week
 

Schedule:
- Monday to Friday
- One early morning or late night per week may be required
- Must be able to attend one monthly meeting before or after normal business hours (advance notice will be provided)
- Must be able to attend one monthly training event before or after normal business hours or on a Saturday (advance notice will be provided)
 

Work Setting:
- In-Person
- Private Practice
 

Benefits:

- 401(k)
- 401(k) Matching
- Accidental Death & Dismemberment (AD&D) Insurance
- Health Insurance
- Health Savings Account
- Dental Insurance
- Disability Insurance
- Life Insurance
- Vision Benefits & Discounted Services
- Employee Assistance Program
- Employee Discount

- Opportunities for Advancement
- Paid Time Off

- Paid Training
- Professional Development Assistance
- Referral Program

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Eye Specialists of Mid-Florida is an Equal Opportunity Employer. We do not discriminate against any individual based on race, color, religion, sex, national origin, age, disability, genetic information, military status, or any other characteristic protected by law. We are a drug and tobacco-free workplace.