Job Description

Job Description

Job Description

Essential Job Functions

• Contact insurance carriers to verify patient’s insurance eligibility, benefits, and requirements
• Reviews documentation to ensure all medical policy guidelines are met
• Request, follow up and secure prior authorizations prior to services being performed including appeals if necessary
• Communicates with patients to discuss prior authorization status
• Demonstrate and apply knowledge of medical terminology, high proficiency of general medical office procedures including HIPAA regulations
• Communicate any insurance changes or trends among team
• Maintains a level of productivity suitable for the department
• Clearly document all communications and contacts with providers and personnel in standardized documentation requirements, including proper format
• Other duties as assigned

Job Knowledge/Skills/Abilities

• High school Diploma or GED
• Previous experience within a clinical setting and/or with health insurance carriers required
• Previous prior authorization experience preferred
• Excellent verbal and written communication skills
• Effective customer relation skills
• Must be highly organized

Physical Demands:

• Independently mobile to perform tasks
• Ability to be seated for up to 8 hours per shift
• Ability to push, pull or lift, up to 60 pounds

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