Authorization Specialist. Job in Salinas LilyLifestyle Jobs

Insurance Verification Specialist This position verifies insurance coverage, benefits and obtains prior authorization for services. Responsibilities MAIN: Contacts insurance plans to determine eligibility and obtain coverage and benefit information. Obtains prior authorization for services. Processes requests for prior authorization for surgery and/or procedure injections Identifies and resolves problems with participant eligibility/insurance coverage Accurately calculates patient responsibility amounts based on benefit information and payer allowable. Documents findings thoroughly and accurately. Prioritizes work to maximize turn-around time. Meets or exceeds productivity standards in the completion of daily assignments and accurate production. Maintain an error rate in accordance with departmental policy. Makes changes to demographic information as necessary in order to produce a clean patient statement. Answer and respond to external and internal phone calls in a timely manner. Check and respond to emails in a timely and professional manner. Performs all other assigned duties. GENERAL DUTIES: Conducts self in accordance with the company's standard values and policies. Participates in a variety of educational programs, corporate and professional, to maintain current skill and competency levels. The Essential Job Functions and Duties and Responsibilities listed above are not exhaustive. The job functions and duties of this job may vary depending upon the specific nature and needs of the department, including size, location and services offered. At some locations, employees may not perform all of the job functions or duties listed above. At other locations, employees may perform some or all of the job functions or duties listed above and, in addition, may be required to perform other job functions or duties as directed. In addition, given the nature of its business, MMRG retains the right to modify the essential job functions and duties of this position at any time. METHOD AND FREQUENCY OF SUPERVISION: Monthly meetings with supervisor. Informal supervision with employee through an open door policy. Employee is expected to ask questions when needed. Qualifications Education: High School diploma or equivalent Prior Experience: Minimum of 1-2 years of insurance verification, referrals, prior authorization, or eligibility experience required experience preferred. Skills and Proficiencies: Active knowledge of CMS guidelines contracted insurance guidelines and coding policies. Demonstrated computer literacy Well-organized with attention to detail Ability to read and understand oral and written instructions Excellent math skills Critical thinking skills are strongly preferred Ability to establish and maintain effective working relationship with team members, clinic staff, payers and patients. Professional customer service skills. Have a desire and dedication to work with self-discipline. Maintains the strictest confidentiality: adheres to all HIPAA guidelines and regulations. Physical Abilities: Ability to sit for long periods. Work requires walking, bending, standing, sitting, and reaching Benefits & Perks Your health, happiness and your future matters! At Vantage Eye Center, we offer everything from medical and dental insurance, significant eye care discounts, child care assistance, pet insurance, continuing education funds, 401(k), paid holidays, PTO, Sick Time, opportunity for growth, and much more! #J-18808-Ljbffr