Job title: Pre-Authorization/Insurance Specialist
Position Summary:
Responsible for insurance verification precertification, preauthorization’s.
Duties and Responsibilities include but are not limited to:
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Assists with the Verification of insurance benefits, eligibility.
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Precertification/preauthorization of indicated studies.
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Ensure that all precertification are done in advance, before the patient is
scheduled for the studies indicated.
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Submits required notes to insure carriers for authorization purpose
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Ensure documents (authorization/data/numbers) are entered into EHR system.
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Alerts the physicians for none covered services
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Communicates with the physicians and Nursing Supervisor with non-supportive
documentation.
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Communicates with all insurance carriers: Medicare, Medicaid, Commercial, PPO,
network benefits, etc.
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Seeks advice and guidance from certified coder with regards to coding guidelines.
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Performs related work as required.
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Practice and adhere to HIPPA regulations.
Qualifications and Specifications:
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Education-High School Diploma some college preferred
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Knowledge of basic office procedures.
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Knowledge of basic office equipment including copier, fax and computer
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Ability to speak clearly and concisely.
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Skills in dealing with interpersonal issues and patient relations.
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Ability to handle multiple priorities at once with minimal supervision.
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Knowledge of Medical Terminology.
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Ability to maintain confidentiality of patient information.
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