Insurance Authorization Rep

Insurance Authorization Representative

NOW HIRING INSURANCE AUTHORIZATION REPRESENTATIVE - REMOTE ABOUT US Blue Cloud is the largest pediatric Ambulatory Surgery Center (ASC) company in the country, specializing in dental restorative and exodontia surgery for pediatric and special needs patients delivered under general anesthesia. We are a mission-driven company with an emphasis on providing safe, quality, and accessible care, at reduced costs to families and payors. As our network of ASCs continues to grow, we are actively recruiting a new Patient Service Coordinator to join our talented and passionate care teams. Our ASC based model provides an excellent working environment with a close-knit clinical team of Dentists, Anesthesiologists, Registered Nurses, Registered Dental Assistants and more. We'd love to discuss these opportunities in greater detail, and how Blue Cloud can become your new home! OUR VISION & VALUES At Blue Cloud, it's our vision to be the leader in safety and quality for pediatric dental patients treated in a surgery center environment. Our core values drive the decisions of our talented team every day and serve as a guiding direction toward that vision. We cheerfully work hard We are individually empathetic We keep our commitments Summary/Objective Perform insurance verification and authorizations. Responsibilities include but not limited to heavy phone contact with dental and medical insurance companies, communicate with insurance companies' authorization department regarding any CPT/CDT code discrepancies (as assigned), and contact patient prior to appointment if there are any insurance/authorization issues. Serves as a valuable resource to patients, providing them with pertinent information regarding their insurance coverage. Essential Functions (Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions). Accurately enter insurance information into computer system. Responsible for pre-certification/authorization and insurance verification for all patients. Obtain prior authorization for procedures. Research follow up and resolve open & pending authorizations in a timely manner. Calculate cash estimates for patients on upcoming visits/procedures. Contact patients regarding financial obligations and arranging payments. Documents activity in the patient accounts. Concisely, precisely and accurately document all information. Maintain clear communication with patients as well as insurance companies. Maintain strict confidentiality of patient and center related business. Scanning medical documents into patient accounts. Answer questions from clinics, patients, insurance companies, and staff. Maintain patient confidentiality and adhere to HIPAA guidelines / regulations. Perform tasks based on set task schedule. Perform general office duties as needed. Competency Customer/Client Focus. Stress Management/Composure. Results Driven. Technical Capacity. Problem Solving/Analysis. Teamwork Orientation. Collaboration Skills. Time Management. Communication Proficiency Supervisory Responsibility This position has no direct supervisory responsibilities. Work Environment This job operates in a professional office environment or can be located remotely in a professional home office. This role routinely uses standard office equipment. Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle, or feel objects, tools or controls; reach with hands and arms; climb stairs; talk or hear. The employee must occasionally lift or move office products and supplies, up to 20 pounds. Position Type/Expected Hours of Work Full time, day shift, Monday through Friday. This position may have occasional overtime. Travel This position requires no travel. Required Education and Experience High School Diploma or Equivalent Ability to effectively handle multiple responsibilities simultaneously in a deadline driven environment. Strong understanding of benefits investigating; deductibles, co-insurance, out of pocket expense & benefit exclusions Preferred Education and Experience Associates degree Additional coursework in medical/dental billing Previous experience with medical/dental billing software systems 3-5 years in a fast-paced medical/dental office environment Knowledge of patient registration, scheduling, authorizations, billing, and dental/medical policies Working knowledge of Medicare, Medicaid, BC/BS, Workers Compensation, Managed Care, and Commercial insurance carriers billing regulations Strong organization, problem-solving and communication skills Requirements None Job Type: Full-time Expected hours: 40 per week Benefits: 401(k) Dental insurance Health insurance Life insurance Paid time off Vision insurance $18-20/hr Remote Opportunity - AZ, ID, TN, MO, TX, MD, CO, FL, DE, IL, KS, MI, NV, NC, OH, PA, WV Experience: Insurance verification: 1 year (Preferred) Medical billing: 1 year (Preferred) Work Location: Remote (Not eligible for CA employees) Blue Cloud is an equal opportunity employer. Consistent with applicable law, all qualified applicants will receive consideration for employment without regard to age, ancestry, citizenship, color, family or medical care leave, gender identity or expression, genetic information, immigration status, marital status, medical condition, national origin, physical or mental disability, political affiliation, protected veteran or military status, race, ethnicity, religion, sex (including pregnancy), sexual orientation, or any other characteristic protected by applicable local laws, regulations and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application process, read more about requesting accommodations. Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.