Referral Coordinator/ Insurance Verification Representative

Job Description

Job DescriptionDescription:

Join the Winning Team!! Insurance specialists wanted for a busy medical practice. Candidates should have a positive attitude, strong work ethic, and be a team player.

Hours:

• Monday-Friday 7:30am- 4:30pm

Essential Functions:

• Verifies insurance eligibility and benefits of prospects/ referrals and determines rate requirements as it relates to in or out of network coverage on a daily basis in an accurate and timely manner
• Communicates patient benefits in a timely manner using the appropriate systems and associated software application as found in patient notes, tasks, workflow, email and or phone calls
• Documents and forwards patient deductible, out-of-pocket expense, life-time maximum, and patient responsibility to agency in an accurate and timely manner
• Reviewsand replies to urgent requests in a timely and accurate manner
• Obtains all authorization as needed from payer for services ordered/requested in a timely manner
• Documents specific details related to the authorization including effective and end dates using the appropriate system and associated software application via patient notes, authorizations, tasks, workflow, phone calls and/or email
• Maintain patient confidentiality, HIPAA compliance
• Serves as a liaison between the clinic and the payer on a regular basis
• Coordinates and communicates within regarding any changes or updates from the payer in a timely manner
• Resolves all customer requests, inquiries, and concerns in an expedient and respectful manner
• Problem solves independently before referring issues to the Supervisor/Manager for resolution
• Performs eligibility and or similar, comparable, or related duties as may be required or assigned
• Adheres to policies/procedures of organization
• Ability to maintain regular attendance is an essential function
• Attend meetings as required

Requirements:

Successful Candidate Should Possess:

• High-School Diploma with additional certifications and/or experience
• Basic and advanced insurance knowledge (plans, copays, deductibles, coinsurance, etc.)
• Medical billing/coding experience
• Medical procedure authorizations experience or ability to learn
• Excellent oral and written communication skills
• Excellent organizational/time management and analytical skills
• Intermediate to advanced computer skills
• Mathematical aptitude
• Self-starter, Team player
• Ability to prioritize workload and multi-task
• Attention to detail
• Demonstrated ability to work independently and as a team player
• Punctuality, Reliability and Honesty
• Positive, pleasant attitude, neat appearance and flexibility