Responsibilities
- Acquire and confirm insurance eligibility for services rendered and record comprehensive details in the system
- Execute prior authorizations as mandated by the payer, including gathering necessary documents by liaising with physician offices and insurance companies
- Gather clinical data such as lab results and diagnosis codes
- Assess the patient's financial obligations as outlined by their insurance
- Manage coordination of benefits information for each referral
- Ensure benefits assignments are secured and documented for Medicare claims
- Submit bills to insurance companies for therapies provided
- Record all relevant communications with patients, physicians, and insurance companies related to collection processes
- Identify and manage patient resources related to reimbursement, including copay cards and assistance programs
- Address incoming calls from patients, physician offices, and insurance companies
- Resolve claim rejections related to eligibility, coverage, and other issues
- Perform additional tasks as assigned
- Adhere to all policies and standards
Requirements
- High school diploma with at least one year of medical billing or insurance verification experience
Nice to Have
- Bachelor’s degree in a related field can substitute for experience
- Experience with payors and prior authorization is preferred
Benefits
- Competitive salary
- Health insurance
- 401K and stock purchase plans
- Tuition reimbursement
- Paid time off plus holidays
Compensation
Competitive
Work Arrangement
On-site
Team
Collaborative
Responsibilities
- Obtain and verify insurance eligibility for services provided and document complete information in system
- Perform prior authorizations as required by payor source, including procurement of needed documentation by collaborating with physician offices and insurance companies
- Collect any clinical information such as lab values, diagnosis codes, etc.
- Determine patient’s financial responsibilities as stated by insurance
- Configure coordination of benefits information on every referral
- Ensure assignment of benefits are obtained and on file for Medicare claims
- Bill insurance companies for therapies provided
- Document all pertinent communication with patient, physician, insurance company as it may relate to collection procedures
- Identify and coordinate patient resources as it pertains to reimbursement, such as copay cards, third party assistance programs, and manufacturer assistance programs
- Handle inbound calls from patients, physician offices, and/or insurance companies
- Resolve claim rejections for eligibility, coverage, and other issues
- Performs other duties as assigned
- Complies with all policies and standards
Not specified
