Preservice Authorization Rep

Description

• Insurance verification and eligibility.


• Insurance pre-authorization / pre-certifications verification and documentation in the billing system as well as electronic document system.


• Seeks ASC admin approval or rescheduling of any non-authorized or low margin cases.


• Contacts and councils patients and families on insurance coverage, patient responsibility and payment issues prior to surgery.


• Ensures all insurance, demographic, and eligibility information is obtained from patients and entered in the billing system in an accurate and timely manner. Registers patients in the system.


• Collects and revises all patient insurance information.


• Collects co-pays, deductibles and other out of pocket amounts prior to or at the time of service by patient request.

Qualifications

Education

• High school diploma or GED required.


• College degree a plus.

Experience

• Two years minimum front office experience in a medical environment.


• Experience with insurance and scheduling.


• Experience with Payor portal, authorization, Payor payment policy and contract reimbursement.

License(s)/Certification(s)

• PSR


• None.

Knowledge/Skills/Abilities

• Strong customer service skills.


• Strong initiative and ability to work in a team environment.


• ICD-10 and CPT code knowledge.

Core Competencies

• N/A

Working Conditions

Physical Requirements

• Talk / Hear


• See


• Stand


• Sit


• Repetitive Use of Hands

Hazards and Atmospheric Conditions

• Normal Office Surroundings

Competencies

Agility

• Resourcefulness: Adapts quickly to changing circumstances; cleverly navigates obstacles and constraints.


• Manages Uncertainty: Comfortable when things are in flux; readily shifts approach or behavior to fit changing circumstances.

Bias to Action

• Action Oriented: Propensity to act or decide and move forward with a logical approach; can decide and act without having the total picture.


• Delivering Results: Strives for high levels of achievement; maintains a clear and steady focus on meeting goals despite obstacles; is resilient when encountering setbacks.

Customer Focus

• Identifying with Customers: Understanding who the external and internal customers are and what they value.

Managing Complexity

• Essence: Extracts the core meaning out of complex situations; can separate the important from the noise when problem solving; hunts for the root cause of successes and failures.

Manages Conflict

• Can hammer out tough agreements and settle disputes equitably.


• Stays positive, constructive, and respectful, even in disagreements or conflicts.

Benefits:

• Comprehensive health, dental, and vision insurance


• Health Savings Account with an employer contribution


• Life Insurance 


• PTO


• 401(k) retirement plan with a company match


• And more! 

ENVIRONMENTAL/WORKING CONDITIONS: Normal busy office environment with much telephone work. Possible long hours as needed. The description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities and working conditions may change as needs evolve.

*If you are viewing this role on a job board such as Indeed.com or LinkedIn, please know that pay bands are auto assigned and may not reflect the true pay band within the organization.

*No Recruiters Please