Duties & Responsibilities
- Perform insurance verifications and authorizations for orthotic and/or prosthetic devices to ensure coverage for each code used for each device ordered for a patient.
- Collaborate with other team members and communicate requirements pertaining to their patient’s insurance coverage.
- Communicate accurate benefits to the patient or applicable customer.
- Explain co-insurance and deductible amounts to patient or applicable customer and collect if possible.
- Process all authorization requests that are required by the patient’s insurance carrier through live communication via phone with carrier’s or using insurance carrier online portals to obtain the most up to date benefit information.
- Create patient account profile in the Medical Record system, manage the collection of medical documentation required to secure authorization for patient cases across all offices, and update patient file with appropriate notes accordingly.
- Communicate any changes in requirements for verification or authorization by insurance carriers to manager for training and compliance updates.
- Answer calls in a timely and professional manner and provide excellent customer service.
- Participate in training programs for continuing learning and development.
- Comply with Corporate Compliance and HIPAA responsibilities.
- Observe and communicate to management any opportunities to streamline processes and improve efficiency in day-to-day operations.
- Perform other duties and special projects as assigned.