Job description

· Answers incoming calls from clients (patients, physicians, insurance companies, etc.) as they relate to inquiries regarding insurance verification, out of pocket expenses, and authorizations.

· Performs outbound calling to physicians, insurance companies, pharmacists, and others clients to follow up on insurance verification and authorizations

· Update insurance verification forms when needed

· Call on any and all insurance companies to verify if authorization is needed and if so, record all and any pertinent information and obtain reference numbers with date and time called.

· Update applicable databases with insurance coverage verified benefits, including coverage effective dates, patient demographic information, emergency contacts, residence addresses, insured relationship if patient is not insured, and any other applicable information required by insurance and program in use.

· Verify all and prepare all appropriate authorization/ gap exception forms

· Adhere to all policies and procedures, with the most stringent attention to complying with all governmental and HIPAA mandated patient confidentiality regulations.

· Identify any issues or problems with payers and the possible difficulties in presenting clean claims to them based upon verification requirements

· Appropriately prioritize all prior authorization requests

· Continuing to keep all choices in regards to the patient’s medical history and patient status up to the provider’s discretion.

· Track and follow up on all pending authorization requests, including obtaining pertinent information required by insurance company and notifying patient/facility when approved.

· Verify provider is in network for each injection and if not, does patient have OON benefits

· Meet and discuss with staff and medical providers for clarification on authorization requests and on the status of authorization

· Call patients and cancel appointments if insurance has denied any procedures, imaging, or prescriptions

· Respond and cooperate with outside billing and prior authorization staff

· Serve and protect the physician or healthcare provider practice by adhering to professional standards, policies and procedures, federal, state and local requirements and Joint Commission on Accreditation of Healthcare Organizations (JCAHO) standards

· Maintain safe, secure and healthy work environment by establishing and following standards and procedures and complying with legal regulations

Job Type: Full-time

Pay: $15.00 - $18.00 per hour

Job Type: Full-time

Pay: $17.84 - $19.63 per hour

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Life insurance
• Paid time off

Schedule:

• Monday to Friday

Education:

• High school or equivalent (Preferred)

Experience:

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

Work Location: One location

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