Overview:
Gathers complete and accurate patient demographic and financial information. Verifies/ identifies insurance plans and
obtains benefit information. Interacts with patients and insurance companies over the phone and solidifies patient arrival
time for the appointment with the patient.
Responsibilities:
Reviews insurance eligibility information and notates account accurately with co-pay and deductible information.
Verifies that the procedure and diagnosis code is the same procedure and diagnosis code as the test ordered
Verifies all authorizations by contacting the insurance company or using online tool
Responsible for reading and interpreting a completed physician order (written or electronic) for appropriate handling
Screens for LMRP’s and identifies when an ABN is required and how to deliver/explain in detail ABN/LMRP process to
the patient as well as the need to obtain a signature for service or gather a new order from the physician’s office that will
meet medical necessity.
Completes Medicare Secondary Payer Questionnaire (MSP) on every Medicare patient.
Operate all essential departmental equipment, maintain adequate supplies at desk and keep work area neat and clean.
Responsible to maintain a three-day window; having all patients registered, insurance verified, pre-certed, completed
etc., for those patients that have scheduled appointments
Qualifications:
High School Diploma/Equivalent
1 year Medical Office, Insurance, Billing/Registration
Medical Terminology and Medical Insurance terminology with emphasis on referral and pre-certification.
