PositionOverview:

Obtain all required authorizations prior to services being rendered at OUI and outside facilities. Verification of insurance coverage and benefits prior to services being rendered and request Deposit if applicable.

 

Essential Job Functions:

    • Verify insurance of scheduled patients including specific benefits for service scheduled
    • Notify patients of deposit requirement
    • Review all scheduled appointments for authorization need.
      • Work closely with Referral coordinators to ensure that Prior Authorized services also have valid Referral as needed.
    • Contact insurance carriers to obtain necessary authorizations.
    • Contact with outside facilities as needed to exchange information regarding Orders and Prior Authorizations
    • Review and take corrective action on denied claims.
    • Work closely with clinical staff to ensure authorizations are obtained for urgent services and add on cases.
  • Perform other duties and special projects as assigned by Manager or Lead.

Requirements

  • Experience working with a window-based PM/EMR.

  • Minimum 2-3 years’ experience working in a related medical office role.

  • Strong communication skills, both written and verbal.

  • Ability to work both independently and as a team.

  • Ability to effectively interact with all levels of company staff, patients and their family members.

  • Ability to maintain a high level of organization and attention to detail in a fast paced environment.

  • Knowledge of CPT and ICD9/10 coding and insurance reimbursement practices.

  • Ability to understand Medical terminology and gather data needed from the Chart to obtain Authorization.

  • Equivalent of a high school diploma.

  • This is a full time/benefited position.
  • NOTE:This job description is not intended to be all-inclusive. Employee may perform other related duties as directed by supervisor to meet the ongoing needs of the organization.

 

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