Insurance Verification & Authorization Specialist

Consider joining Thurmond Eye Associates/Ascend Vision Partners and join a team that are focused on building a differentiated integrated eye care platform focused on superior patient care delivered through our network of optometrists and ophthalmologists. Team members are expected to exhibit a continuous behavior of professionalism, which includes but is not limited to, acting with integrity and accountability, support our clinicians in all aspects of patient care delivery, support a culture of respect, diversity and inclusion in our organization, and enhance the patient access to primary and specialty eye care. Our vision is to create an admired healthcare company dedicated to delivering personalized eye care with outstanding patient outcomes.    

Summary

The Insurance Authorization and Verification is responsible for the completion of insurance authorization and verification experience for ophthalmology & optometry appointments, in-office procedures and surgical procedures. 

Essential Duties & Responsibilities: 

• Maintains patient demographic information and data collection systems.
• Verifies insurance eligibility for both medical and vision insurances for upcoming appointments by utilizing online websites or by contacting the carriers directly.
• Obtains referrals from the PCP or authorizations from the insurance prior to the upcoming appointment.
• Consistently communicate with the patient on the status of the referral or authorization prior to the appointment. 
• Reviews patient deductibles and/or copays and document in notes sections as well as the pop-ups in the billing system.
• Assists front desk staff and call center staff in understanding verification of eligibility or status of the referral and/or the authorization. 
• Verifies accuracy of referral / authorization and enter in to Managed Visits. 
• Participates in development of organization procedures and update of forms and manuals.
• Answers questions from patients, clerical staff, and insurance companies.
• Works in conjunction with the front desk staff and surgical schedulers to ensure clean billing. 
• Manage and utilize time effectively, assist others within the department, to ensure department meets required service levels.

 Required Education and Experience:

• High School Diploma or GED equivalent
• Minimum of 1-year relevant experience in insurance verification and authorization in a medical office and/or training, or equivalent combination of education and experience.

Core Competencies:

• Proficient in computers and relevant software applications and practice management technology.
• Possession of strong problem-solving skills and sound judgement.
• Ability to collaborate across departments and build effective relationships with internal and external customers to achieve goals.
• Knowledge of customer service principles and practices.
• Ability to achieve team goals while demonstrating organizational values and utilizing resources responsibly. 
• Ability to be proactive and take initiative.
• Exhibit high level of quality through attention to detail and monitoring work.
• Possession of strong organizational skills.
• Excellent verbal and written communication, as well as exceptional interpersonal communication skills. 
• Ability to work independently on assigned tasks, as well as to accept direction on given assignments.
• Deals with confidential information and/or issues using discretion and judgement.

Preferred Experience:

• Prior insurance verification and authorization experience for ophthalmic surgical procedures.

Work Environment & Physical Demands:

• Work is performed in an office setting. 
• Physical demands of position: sitting, standing, walking, typing, phone communication, face to face conversation.