- High School Diploma or GED
- Basic Computer Skills
- Insurance Verification
Under general supervision, this individual is responsible for processing pre-authorization and pre-certification on all out-patient encounters to third party payers.
Experience in a lead role providing technical assistance to staff preferred. Insurance verification and authorization experience preferred.Four years experience previous registration/admitting and/or physician office experienceWorking knowledge of healthcare registration, insurance referral and authorization processes. Ability to communicate with public in a professional and courteous manner.
Initiates and tracks referrals and insurance verification and authorizations for all outpatient encounters in the Tunnell Cancer Center. Utilizes third party payer websites and telephone to retrieve coverage verification and information. Documents insurance coverage restrictions, referrals, and authorizations in the outpatient chart. Also inputs authorization numbers into Aria. Identifies issues and problems with referral/insurance verification processes, analyzes current processes, and recommends solutions and improvements. Coordinates and schedules services with appropriate outside agencies (such as home infusion, mail order medications, etc.) for patients based on their insurance coverage. Provides agencies with physician orders and other requested information. Researches delays in service and discrepancies of orders. Assists supervisor, director, financial services staff with denial issues by providing accurate supporting data. Develops and maintains a good working rapport with interdepartmental personnel such as; patient access, financial services, billing, ancillary and administrative areas. Assists oncology registrars with interviewing patient or patient representatives to obtain demographic and insurance information necessary for medical record identification, registration and bill processing. Assist in care and maintenance of equipment and supplies. Alerts supervisor to malfunction of equipment and/or call for maintenance/repair. Performs other duties as assigned.
Competencies and skills:Essential:
- Clear Communication Skills Both Written And Verbal
- Knowledge Of Basic Computer Programs
- Able To Keep Confidential Information Regarding Patients, Team Members
- Able To Withstand Crisis Situations
- Has Skills To Provides Customer Service To Patients, Team Members And Visitors
- Experience Or Completed Courses In Coding
- Experience With Insurance Verification/ Authorizations
- Experience With Or Completed Course In Medical Terminology
- High school graduate or equivalent
BHC Health Campus-Building 2 BMC
Monday - Friday 8 hour Day Shift