Referral Coordinator/ Insurance Verification Representative

Description

Join the Winning Team!! Insurance specialists wanted for a busy medical practice. Candidates should have a positive attitude, strong work ethic, and be a team player. 

Hours:

• Monday-Friday 7:30am- 4:30pm 

Essential Functions:

• Verifies insurance eligibility and benefits of prospects/ referrals and determines rate requirements as it relates to in or out of network coverage on a daily basis in an accurate and timely manner 
• Communicates patient benefits in a timely manner using the appropriate systems and associated software application as found in patient notes, tasks, workflow, email and or phone calls 
• Documents and forwards patient deductible, out-of-pocket expense, life-time maximum, and patient responsibility to agency in an accurate and timely manner 
• Reviewsand replies to urgent requests in a timely and accurate manner 
• Obtains all authorization as needed from payer for services ordered/requested in a timely manner 
• Documents specific details related to the authorization including effective and end dates using the appropriate system and associated software application via patient notes, authorizations, tasks, workflow, phone calls and/or email 
• Maintain patient confidentiality, HIPAA compliance 
• Serves as a liaison between the clinic and the payer on a regular basis 
• Coordinates and communicates within regarding any changes or updates from the payer in a timely manner 
• Resolves all customer requests, inquiries, and concerns in an expedient and respectful manner 
• Problem solves independently before referring issues to the Supervisor/Manager for resolution 
• Performs eligibility and or similar, comparable, or related duties as may be required or assigned 
• Adheres to policies/procedures of organization 
• Ability to maintain regular attendance is an essential function 
• Attend meetings as required

Requirements

Successful Candidate Should Possess:

• High-School Diploma with additional certifications and/or experience 
• Basic and advanced insurance knowledge (plans, copays, deductibles, coinsurance, etc.) 
• Medical billing/coding experience 
• Medical procedure authorizations experience or ability to learn 
• Excellent oral and written communication skills 
• Excellent organizational/time management and analytical skills 
• Intermediate to advanced computer skills 
• Mathematical aptitude 
• Self-starter, Team player 
• Ability to prioritize workload and multi-task 
• Attention to detail 
• Demonstrated ability to work independently and as a team player 
• Punctuality, Reliability and Honesty 
• Positive, pleasant attitude, neat appearance and flexibility