Insurance Verif Auth Team

Under direct and indirect supervision of the Billing/Insurance Manager and/or Executive Director/Outpatient Imaging Administrator, accurately and efficiently verify patient insurance benefits and obtain necessary authorizations and referrals for services rendered at MRI & CT Diagnostics. Confirm deductibles, co-payments, cost-shares, and patient responsibility in a polite and professional manner.

Major Job Functions

Training and Leading New Employees, to Include:

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  Phone etiquette

  
  


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  Navigating the patient system

  
  


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  Navigating websites for authorizations and benefits

  
  


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  Training in how to obtain authorizations and benefits

  
  


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  Calculating copays

  
  


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  Daily operations

  
  


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  Ensuring the employee is able to perform daily Insurance and Authorization job functions

  
  


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  Reporting to the manager on the new employee’s progress

  
  

Secondary Job Functions

These responsibilities are to be completed as needed and alongside training responsibilities:

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  Verify insurance coverage and benefits for all scheduled patients at least 24–48 hours in advance

  
  


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  Confirm accurate billing address of carrier and contact person when appropriate

  
  


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  Confirm patient demographics, referring physician information, and other chart information is accurate

  
  


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  On behalf of the referring physician, obtain authorization for services from the insurance company if required

  
  


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  Process patient and insurance carrier telephone calls

  
  


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  Contact patient and/or referring physician when insurance coverage cannot be verified

  
  


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  Notify patient of any co-payments, cost-shares, or deductibles

  
  


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  Communicate with Scheduling Department when authorization cannot be obtained

  
  


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  Communicate with the front desk regarding any special circumstances

  
  


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  Properly notate accounts of all communications with patients

  
  


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  Ensure that copies of all referrals, written authorizations, and authorization numbers are entered in the patient RIS record and provided to the billing department

  
  


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  Obtain necessary clinical records to facilitate obtaining authorization

  
  


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  Contact attorney, verify representation and billing address, date of accident or injury; instruct front desk personnel to obtain patient signature on lien letter

  
  


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  Review authorization letters for accuracy

  
  


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  Refer patients with special payment circumstances to management

  
  


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  Communicate changes in insurance company requirements with staff and management

  
  


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  Maintain the current exam board as well as the pending board

  
  

Qualifications

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  High School Diploma

  
  


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  Previous healthcare experience preferred; courses in medical terminology preferred

  
  


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  Ability to operate copier, fax machine, and computer

  
  


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  Must have excellent organizational, communication, and interpersonal skills

  
  


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  Ability to set priorities and manage varying workload

  
  

Specifications

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  Must be able to remain calm in stressful situations

  
  


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  Must display courtesy and empathy toward coworkers and physicians

  
  


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  Must be able to make sound judgments and execute appropriate actions based on knowledge of departmental policies and procedures

  
  


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  Must be discreet with confidential information and abide by corporate HIPAA policies

  
  


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  Must be able to move about freely; sits, stands, and walks intermittently during the day

  
  


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  Must possess sufficient visual and auditory acuity, and manual dexterity to perform tasks

  
  


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  Must attend mandatory practice training and departmental requirements annually

  
  


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  Works in a clean, well-lit medical facility; subject to electrical, chemical, magnetic, and radiant energy hazards; exposure to infectious disease and lifting hazards; must stoop and bend in the course of job performance