Job Description
Job Description
Description :
This person is responsible for insurance verification, obtaining prior authorizations, bill insurance claims and follow-up.
- Obtain authorizations, referrals, GAP exceptions, and Single Case Agreements
- Manage and prioritize required approvals with consistent follow-up while constantly communicating with the team
- Provide clinical documentation to insurance companies to ensure timely authorization.
- Initiate appeals for upfront denied authorizations and follow through until completion
- Check eligibility and benefits
- Electronic claims building and submission
- Chart and coding review
- Call patients when necessary to verify insurance information
- Read and analyze EOBs and ERAs
- Work claims rejects / denials, send corrected claims, submit appeals
- Stay up to date on CPT, ICD, and LCD guidelines
- Provide excellent customer service and professionalism to patients
Requirements :
Skills, Minimum Qualifications
High school diploma or GED2 years prior experience insurance verification or medical billing required2 years prior experience in a medical related field requiredAbility to multi-task and remain focused while managing a high volume, time-sensitive workloadDemonstrate excellent communication and customer service skillsExpected to be detailed oriented with above average organizational skillsExpected to understand payer medical policies and guidelines and use these guidelines to manage authorizations effectivelyFamiliarity with both governmental and commercials insurance plansExpected to have knowledge of medical terminology related to multispecialty surgical proceduresExpected to have excellent computer skills including Excel, Word and Internet useReliable to work scheduled shifts with limited unplanned absences.Please note that this position is not remote and requires employees to travel to work location.