Job Type
Full-time
Description
This person is responsible for insurance verification, obtaining prior authorizations, bill insurance claims and follow-up.
· Obtain authorizations, referrals, GAP exceptions, and Single Case Agreements
· Manage and prioritize required approvals with consistent follow-up while constantly communicating with the team
- Provide clinical documentation to insurance companies to ensure timely authorization.
- Initiate appeals for upfront denied authorizations and follow through until completion
- Check eligibility and benefits
- Electronic claims building and submission
- Chart and coding review
- Call patients when necessary to verify insurance information
- Read and analyze EOBs and ERAs
- Work claims rejects/denials, send corrected claims, submit appeals
- Stay up to date on CPT, ICD, and LCD guidelines
- Provide excellent customer service and professionalism to patients
Requirements
Skills, Minimum Qualifications
- High school diploma or GED
- 2 years prior experience insurance verification or medical billing required
- 2 years prior experience in a medical related field required
- Ability to multi-task and remain focused while managing a high volume, time-sensitive workload
- Demonstrate excellent communication and customer service skills
- Expected to be detailed oriented with above average organizational skills
- Expected to understand payer medical policies and guidelines and use these guidelines to manage authorizations effectively
- Familiarity with both governmental and commercials insurance plans
- Expected to have knowledge of medical terminology related to multispecialty surgical procedures
- Expected to have excellent computer skills including Excel, Word and Internet use
- Reliable to work scheduled shifts with limited unplanned absences.
Please note that this position is not remote and requires employees to travel to work location.