Insurance Coordinator

Shirley Ryan AbilityLab is the global leader in physical medicine and rehabilitation for adults and children with the most severe, complex conditions. By joining our team, you'll be part of our life-changing mission and vision. You'll contribute to an innovative, multifaceted culture that is second to none - one that embraces collaboration, excellence, discovery and compassion. You'll play a role in something that's never been done before as we integrate science and clinical care to help patients achieve better, faster outcomes - as we Advance Human Ability, together. Job Description Summary The Insurance Authorization Coordinator will determine eligibility for third party payer benefits and obtains initial financial authorization when required; including expediting response to referral inquiry, insuring benefits are available to cover, obtaining insurance authorization, assessing clinical information of referral and obtaining social and demographic information to support authorization or referral process. Notifies patient/family and clinical area if third party coverage will not reimburse any or all of the planned care. Identifies alternative payment options to the patient/family and refers appropriate cases to the Care Manager. The Insurance Authorization Coordinator will consistently demonstrate support of the Shirley Ryan AbilityLab (SRAlab) statement of Vision, Mission and Core Values by striving for excellence, contributing to the team efforts and showing respect and compassion for patients and their families, fellow employees, and all others with whom there is contact at or in the interest of the institute. The Insurance Authorization Coordinator will demonstrate Shirley Ryan AbilityLab Core Attributes: Communication, Accountability, Flexibility/Adaptability, Judgment/Problem Solving, Customer Service and Core Values (Hope, Compassion, Discovery, Collaboration, & Commitment to Excellence) while fulfilling job duties. Job Description The Insurance Authorization Coordinator will: Research and verify financial coverage with third-party payers for planned services prior to patient's scheduled appointment, which includes completing authorization requirements for the patient's specific plan and communicating limitations or denials to patient/family Refer cases to outpatient Care Managers or Social Workers when patients are unable to pay for services or services are not covered under a third-party payer. Document receipt and forwards appropriate forms (such as a primary care physician referral or a signed agreement to self-pay) to Patient Financial Services. Document all financial clearance information in Information System. Coordinate Clinic referral and authorization processes including expediting response to referral inquiry, insuring benefits are available, obtaining insurance authorization, assessing clinical information of referral and obtaining social and demographic information to support. Screen and respond to requests for general information regarding SRAlab services and programs. Identify and verifies patient benefits and initiates the pre-certification process by accessing insurance company, Medicare, and/or Medicaid data bases. Identify and implements improvements to enhance efficiency and outcomes and to solve unique or complicated problems. Update demographic, insurance, funding and medical information in SRAlab's Information System, as needed. Communicate information to the outpatient clinical team or SRAlab inpatient Care Managers as needed. Communicate all actual or potential denials to Financial Clearance Supervisor. Perform all other duties that may be assigned in the best interest of SRAlab. Reporting Relationships Reports directly to the Administrative Director DayRehab Services Knowledge, Skills & Abilities Required Minimum educational requirements high school degree or equivalent, Associate College degree preferred. Minimum of 2 years of experience normally acquired through prior insurance authorization or pre-certification exp. Knowledge of rehabilitation medicine preferred Working knowledge of Windows operating environment and Microsoft Office software applications. Strong customer service and interpersonal skills necessary to interact with all levels of SRAlab personnel, physicians, insurance representatives, and other internal and external customers. Analytical skills necessary to ensure complete, accurate and timely financial clearance is obtained for all outpatients receiving rehabilitation services at SRAlab. Proficiency in keyboarding skills. Application of a variety of a variety of moderately complex computer PC software. Working Conditions: Normal office environment with little or no exposure to dust or extreme temperature. The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, d #J-18808-Ljbffr sralab