Job Description
ESSENTIAL FUNCTIONS:
• Determine patient co-payments and calculate co-insurance and deductibles
• Enter accurate insurance information, including co-payments and deductibles, into patient records
• Prioritize incoming authorization requests based on urgency
• Initiate and assist with appeals for denied authorizations
• Communicate effectively with patients, healthcare providers, and relevant parties regarding procedures
• Follow-up to ensure all necessary documentation is obtained and complete
• Schedule and reschedule patient follow-ups and procedures as needed
• Provide patients with essential information and instructions before their procedure date
• Send prescriptions to pharmacies via fax or email
• Ensure patients move through scheduled appointments efficiently
• Answer phone calls and respond to patient inquiries
• Update and maintain accurate patient information in the database
• Submit patient information to the verification department for pre-authorization
• Ensure completeness and accuracy of all patient forms and documentation
• Perform other related tasks as needed
KNOWLEDGE, SKILLS, AND ABILITIES:
• Knowledge of in-network and out-of-network insurance, as well as patient financial responsibilities
• Familiarity with ICD-10 and CPT codes and medical procedures
• Ability to review and comprehend patient medical documentation
• Ability to independently identify and understand medical necessity requirements
• Strong task management and organizational skills with the ability to complete tasks in a timely manner
• Detail-oriented, ensure accuracy and thoroughness in all tasks
• Ability to work both independently and collaboratively as part of a team
• Adaptability and flexibility in a dynamic work environment
• Effective written and verbal communication skills
EDUCATION AND EXPERIENCE:
• High School Diploma or GED
• One (1) year of experience in a medical facility
• Basic Life Support (BLS) Certified
