Under the direct supervision of the Practice Administrator, performs a variety of duties in support of a physicians’ practice following established methods and procedures. Contacts insurance companies and other third-party payers to determine pre-certification, pre-authorization and/or medical necessity requirements for complex outpatient vein procedures, and specialized diagnostic testing (i.e. abdominal ultrasounds). Obtains patient benefits and determines patient out of pocket expenses for vein procedures, communicates high out pocket to Practice Administrator to assist patient in financial counseling and payment plans. Liaisons with physicians and physician office staff when needed to obtain additional demographic, insurance or clinical information. Tracks insurance changes and requirements for procedures and testing and communicates the changes to the Practice Administrator. Coordinates with Insurance AR Denials Rep on precertification denials and patient benefits discrepancies from insurance company. Assists Practice Administrator in other tasks as assigned.
Requirements
Must have positive attitude and demeanor, putting focus entirely on providing our patients with the best possible experience at our practice.
Must have strong people skills
Must possess a strong knowledge of medical insurance
Must be motivated and goal oriented
Must possess great time management skills and organizational skills with the ability to prioritize
Must have excellent written and oral communication skills
Must be a team player and willing to work in multiple areas
MINIMUM EDUCATION REQUIRED:
High school diploma or GED
MINIMUM EXPERIENCE REQUIRED:
Three (3) yrs exp in medical precertification or related exp in healthcare.
MINIMUM LICENSURE/CERTIFICATION REQUIRED BY LAW:
None
ADDITIONAL QUALIFICATIONS:
Four (4) years of previous related healthcare Prior authorization experience preferred. Prior eClinical Works EMR experience preferred. Clinical experience (i.e. medical assistant, surgical tech) is a plus.
Job Type: Full-time
Pay: $16.00 – $20.00 per hour
Benefits:
Schedule:
Experience:
Work Location: One location
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