"Exempt/Non Exempt: Non Exempt
Years Experience: min. 1 yr.
Skills: understanding of Medicare rules and regulations; understanding of managed care as it relates to benefits and authorizations; advanced MS Office experience; strong verbal and written communication skills;
Education: min. HS diploma or GED equivalent
Duties: Contacts insurance companies to verify insurance benefits; initiates pre-authorization requests for new and ongoing services with insurance companies and performs follow up activities for an outcome; files Appeals for denied coverage to insurance companies as needed; maintains customer records in practice management system related to benefit coverage, coordination of benefits, authorizations, denials, appeals, outcomes and communication with insurance company; coordinates and communicates with other departments as needed to obtain necessary information to complete benefit verification, authorization, appeals and outcomes for services of care; provides customers with information that includes but is not limited to: updates on status of authorizations, developing & communicating patient financial responsibility estimates, and collecting co-pays, if applicable; applies knowledge of company procedures, contracted and non-contracted guidelines to process cases accordingly and to respond to incoming correspondence and documentation as well as updating customer records according to outcomes; performs other related duties as assigned." •
Last updated on Nov 2, 2023