Position Purpose:
- Obtain and verify complete insurance information, including the prior authorization process, copay assistance and coordination of benefits
- Obtain and verify insurance eligibility for services provided and document complete information in system
- Perform prior authorizations as required by payor source, including procurement of needed documentation by collaborating with physician offices and insurance companies
- Collect any clinical information such as lab values, diagnosis codes, etc.
- Determine patient’s financial responsibilities as stated by insurance
- Configure coordination of benefits information on every referral
- Ensure assignment of benefits are obtained and on file for Medicare claims
- Bill insurance companies for therapies provided
- Document all pertinent communication with patient, physician, insurance company as it may relate to collection procedures
- Identify and coordinate patient resources as it pertains to reimbursement, such as copay cards, third party assistance programs, and manufacturer assistance programs
- Handle inbound calls from patients, physician offices, and/or insurance companies
- Resolve claim rejections for eligibility, coverage, and other issues
Education/Experience:
- High school diploma with 1+ years of medical billing or insurance verification experience
- Bachelor’s degree in related field can substitute for experience
- Experience with payors and prior authorization preferred
- Strong customer service skills