Job description

We are looking for a professional, upbeat insurance precertification specialist to join our front office team in Mt Airy, NC. Experience with Rehabilitation Services is a plus.

Individual will be responsible for assuring appropriate insurance/benefit verification, prior approval and that all authorization requirements are met for patient appointments. Responsible for accurately updating patient benefit information and verify that existing information is correct. Is a valuable resource to patients providing them with pertinent information regarding coverage amounts provided by their insurance policy. Make phone calls to discuss patient financial responsibility. Position requires accuracy and attention to detail, flexibility, excellent communication, customer service skills, and the ability to follow specific procedures. Should have knowledge of medical terminology, insurances and use of Meditich (Expanse), Outlook, and other systems as well as demonstrate the ability to learn new processes and systems quickly. Keeps abreast of all new policies and procedures as they change. Should have knowledge of medical procedures, terminology, insurances and insurance policy and procedures.

MENTAL & VISUAL DEMANDS:

Employees must have excellent communication skills, a professional demeanor, accuracy and attention to detail, flexibility and competency in custom relations skills in a professional environment. Must have high energy, be able to work under time constraints, meet daily deadlines and manage workloads with minimum supervision. Ability to learn new systems quickly as well as constant computer usage are required to work with in Meditech Expanse and other systems used for creating accounts, verifying insurance and demographics and contacting patients. Must have the ability to remain calm, work effectively as a team member and professional, project a positive public image, and keep all information confidential. Responsible for using various computer systems to create accounts, and contact patients to discuss financial responsibilities. Possess good problem-solving skills.

WORK ENVIRONMENT:

Upbeat but fast paced environment in which information is constantly changing.

REQUIRED QUALIFICATIONS:

· Excellent customer service skills

· Computer skills in Microsoft Office, Meditech Expanse, Experian Health, and Internet

· High School diploma/GED

· Associate Degree in Medical Office Administration, or Billing and Coding

· Minimum of two (2) years’ experience in same/related field

· Experience with insurance carriers or a third-party administrator

· Familiar with ICD 10 and CPT codes

• Well organized and able to multi-task quickly and effectively
• Self-motivated, enthusiastic and detail oriented individual with great organizational skills that can work well with deadlines
• Basic understanding of the benefits investigation process which includes deductible, out of pocket and benefit exclusions

RESPONSIBILITIES:

· Must be able to accurately document and verbalize issues and have the ability to work with in a team environment and across departments

· Prepare and complete payer-specific prior authorization request forms, interpret medical policy criteria, and apply appropriate guidelines to prior authorization requests

· Research, follow-up, and resolve all open/pending authorizations in a timely manner

· Communicate and coordinate with interdepartmental and interoffice personnel to procure correct and detailed information regarding authorizations

· Obtain authorizations for worker’s comp or other services as needed

· Verify current patient demographic information to ensure all demographic data is accurate when possible.

· Utilize insurance payer sites and customer care to obtain benefit information

· Contact patients regarding financial obligation for upcoming appointment and assist with any questions regarding insurance coverage or estimates

· Follow up on post-claim denials

· Responsible for notifying the appropriate internal departments based on receipt of information that department needs to be aware of including complaint handling/ adverse event notifications

· Maintain excellent customer relations with patients, family members, and staff

MISCELLANEOUS:

· Adhere to all policies and procedures related to compliance, general, and patient safety, infection control, ethical conduct

· Maintain acceptable attendance, which includes providing proper notification and advance notice for absence/tardiness. Return from lunch and break promptly

· Ensure strict confidentiality of Protected Health Information (PHI) at all times

· Work cooperatively and as a team player with co-workers

· Utilize excellent customer service skills

· Perform additional duties as assigned

(*salaries are autogenerated by indeed-Pay will be based on location and commensurate upon experience)

Job Types: Full-time, Part-time

Pay: $26,912.32 - $35,260.95 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift

Ability to commute/relocate:

• Mount Airy, NC 27030: Reliably commute or planning to relocate before starting work (Required)

Experience:

• Medical billing: 1 year (Preferred)
• Insurance verification: 2 years (Required)

Work Location: In person

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