Insurance Verification Specialist | Authorization Specialist

Overview

Looking for full-time work (8 hours/day)

at $11.56/hour ($2,034.56/month)

High school diploma

Last Active

June 10th, 2024 (7 days ago)

Member Since

December 10th, 2022

Profile Description

Perform financial verification of insurance eligibility and benefits to determine payment responsibility
Ensure all payer forms, notifications, and authorizations are completed within the required timeframe
Calculate accurate patient financial responsibility
Document patient information in the billing database according to the insurance verification guidelines to assure accurate and timely reimbursement
Review provider's treatment plan and make sure the planned procedure will meet medical necessity of the payer
Submit prior authorization request thru different portals like Evicore, Carelon and Cohere
Submit authorization request thru insurance calling and provide clinicals if necessary
Coordinating with providers with any authorization denials to determine whether or not to schedule a peer to peer review or to file a pre-service appeal
Schedule patient appointments, exams and procedures, and process forms and data
Checks patient in, verifies and updates necessary information in EMR
Process payments received in person and by mailGreet patients and provide superior patient relations
Receive referrals from physicians and facilities
Answer incoming calls (heavy call volume), verify patient insurance benefits, and administer patient registration
Schedule and confirm patient appointments within EMR
Communicate with referring offices regarding patient appointment status
Maintaining accounts receivable ledger and ensuring timely payment from insurance companies
Following up on unpaid claims to ensure payments are made and correcting and resubmitting denied claims to ensure payments have been made
Secure outstanding balance payments
Interpret payer coverage information including network participation status with the provider, limited plan coverage, and inactive benefits.