The insurance verification, benefits, and referral coordinator is responsible for the insurance verification of all insurance plans. Insurance benefits and procedures are verified utilizing on-line insurance website resources or research which may require outbound phone calls to insurance companies. The coordinator will also obtain any referral that is required for office visits and any authorization or pre-certification that is required for in office procedures required to verify the insurance. The coordinator is also responsible for all follow-up! Once the insurance has been confirmed active, benefits are documented in the EMR and Travel Card system.

Essential duties and responsibilities are as follows:

~ Initiates prior authorizations, pre-determinations, and out-of-network gap exceptions.

~ Initiates and follows through with authorization appeals.

~ Follows up on all authorization requests in a timely manner and reports on progress to internal teams.

~ Negotiates and obtains agreements with insurance companies for individual cases when necessary.

~ Communicates internally and externally regarding authorizations, appeals, and exceptions.

~ Assists in eligibility and benefits inquiries when necessary.

~ Determines the authorization requirements of each health plan and keeps detailed record of the medical policies and requirements.

~ Maintains accurate and complete documentation of all inquiries.

~ Proactively communicates with team members regarding identified potential issues and concerns.

~ Track patterns and trends of authorization issues from payers to eliminate future delays in authorization process.

~ Exhibits strong problem-solving skills through both verbal and written communications.

~ Assists reimbursement team in authorization related corrections on rejected or denied claims.

~ Answers in-bound calls and assists customers.

~ Exercise the above with discretion and independent judgment.

~ Performs other duties and works on special projects to authorization.

Job Type: Full-time

Pay: $13.00 - $18.00 per hour

Benefits:

• Employee assistance program
• Employee discount
• Paid time off

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday
• No weekends
• Overtime

Supplemental pay types:

• Bonus pay

COVID-19 considerations:
Covid Protocols in place

Education:

• High school or equivalent (Required)

Experience:

• Insurance verification: 1 year (Required)
• Medical billing: 1 year (Required)

Work Location: One location

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