At OAM everything we do is about providing compassionate care, patient satisfaction, and the best outcomes for those we serve. We are able to do this by having a dedicated workforce who are innovative thinkers, bring exceptional results in quality, are team oriented, and take ownership of the success of their job, the department they support, and OAM itself.

POSITION SUMMARY

With customer service orientation, verifies patient's insurance benefits and eligibility, obtains required authorization, provided procedure codes and fee estimates, and collects prepayment from patients when appropriate.

ESSENTIAL RESPONSIBILITES

• Monitor new patient report and maintain organized list with status of pre-certification process.
• Verify insurance eligibility and benefits via phone and/or internet access. Update insurance policy information in NextGen system as required.
• Check insurance payment policy for scheduled procedures and obtain prior authorization when required.
• Verify receipt of all necessary pre-authorization documents prior to procedure
• Communicate effectively with the facility in which the procedure will be performed as needed.
• Assign appropriate ICD10 and CPT codes pre-operatively based on documentation and booking slips.
• Notify primary care physician for managed care plans that require PCP authorization.
• Serve as a resource on insurance, billing and customer service for reception and cashier.
• Perform other duties or functions as assigned

REQUIRED/DESIRED QUALIFICATIONS

Education, Training and Experience:

• At least two years of insurance verification and authorization experience. Employee must have extensive knowledge of anatomy, physiology and medical terminology.

Specific skills, knowledge and abilities:

• Presents a strong professional appearance
• Strong verbal communication skills
• Working knowledge of medical billing and managed care
• Proven experience handling irate patients/customers and dealing with conflict
• Familiarity with different insurance types
• Highly organized and self-motivated
• Microsoft Office and Windows based computer applications

Motor, sensory and physical requirements:

• Ability to sit for prolonged periods of time.
• Frequent bending, stooping, lifting and reaching required
• Employee may be required to lift up to 50 pounds.
• Manual dexterity required to operate modern office equipment.
• Employee must have normal or correctible range of hearing and eyesight.

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