Insurance Verif Auth Team

Insurance Verif Auth Team

Job Category: Patient Access Services

Full-Time

On-site

Virginia Beach, VA 23462, USA

Description

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:

• Phone etiquette
• Navigating the patient system
• Navigating websites for authorizations and benefits
• Training in how to obtain authorizations and benefits
• Calculating copays
• Daily operations
• Ensuring the employee is able to perform daily Insurance and Authorization job functions
• 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:

• Verify insurance coverage and benefits for all scheduled patients at least 2448 hours in advance
• Confirm accurate billing address of carrier and contact person when appropriate
• Confirm patient demographics, referring physician information, and other chart information is accurate
• On behalf of the referring physician, obtain authorization for services from the insurance company if required
• Process patient and insurance carrier telephone calls
• Contact patient and/or referring physician when insurance coverage cannot be verified
• Notify patient of any co-payments, cost-shares, or deductibles
• Communicate with Scheduling Department when authorization cannot be obtained
• Communicate with the front desk regarding any special circumstances
• Properly notate accounts of all communications with patients
• Ensure that copies of all referrals, written authorizations, and authorization numbers are entered in the patient RIS record and provided to the billing department
• Obtain necessary clinical records to facilitate obtaining authorization
• Contact attorney, verify representation and billing address, date of accident or injury; instruct front desk personnel to obtain patient signature on lien letter
• Review authorization letters for accuracy
• Refer patients with special payment circumstances to management
• Communicate changes in insurance company requirements with staff and management
• Maintain the current exam board as well as the pending board

Qualifications

• High School Diploma
• Previous healthcare experience preferred; courses in medical terminology preferred
• Ability to operate copier, fax machine, and computer
• Must have excellent organizational, communication, and interpersonal skills
• Ability to set priorities and manage varying workload

Specifications

• Must be able to remain calm in stressful situations
• Must display courtesy and empathy toward coworkers and physicians
• Must be able to make sound judgments and execute appropriate actions based on knowledge of departmental policies and procedures
• Must be discreet with confidential information and abide by corporate HIPAA policies
• Must be able to move about freely; sits, stands, and walks intermittently during the day
• Must possess sufficient visual and auditory acuity, and manual dexterity to perform tasks
• Must attend mandatory practice training and departmental requirements annually
• 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

Education

High School or better in General Studies.

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.

Chesapeake Regional Healthcare