Verification and Authorization Specialist

Description

Consider joining Ascend Vision Partners and join a team that are focused on building a differentiated integrated eye care platform focused on superior patient care delivered through our network of optometrists and ophthalmologists. Team members are expected to exhibit a continuous behavior of professionalism, which includes but is not limited to, acting with integrity and accountability, support our clinicians in all aspects of patient care delivery, support a culture of respect, diversity and inclusion in our organization, and enhance the patient access to primary and specialty eye care. 

Our vision is to create an admired healthcare company dedicated to delivering personalized eye care with outstanding patient outcomes.  

Reporting to the Senior Billing Manager, the Verification and Authorization Specialist will have prior medical insurance experience. He or she must possess the desire to learn and grow with a company that is rapidly expanding.   

ESSENTIAL DUTIES & RESPONSIBILITIES:

• Maintains patient demographic information and data collection systems.
• Verify insurance eligibility for both medical and vision insurances for upcoming appointments by utilizing workflow tool, online websites or by contacting the carriers directly.
• Obtain referrals from the PCP or authorizations from the insurance prior to the upcoming appointment.
• Consistently communicate with the patient on the status of the referral, authorization, and/or request for updated benefit coverage prior to the appointment. 
• Review patient deductibles and/or copays and document in notes sections as well as the pop-ups in the billing system.
• Assist front desk staff and call center staff in understanding verification of eligibility or status of the referral and/or the authorization. 
• Collect patient copays, deductibles and other out of pocket responsibilities prior to appointment and/or surgery/procedure.
• Verify accuracy of referral / authorization and enter in to Managed Visits. 
• Participate in development of organization procedures and update of forms and manuals.
• Answers questions from patients, clerical staff, and insurance companies.
• Works in conjunction with the front desk staff and surgical schedulers to ensure clean billing. 

Requirements

EDUCATION & EXPERIENCE:

• Minimum of 1-year relevant insurance verification and authorization experience and/or training in a physician office, or equivalent combination of education and experience.
• Proficient in computers and relevant software applications and practice management technology.
• Possession of strong problem-solving skills and sound judgement.
• Ability to collaborate across departments and build effective relationships with internal and external customers to achieve goals.
• Knowledge of customer service principles and practices.
• Ability to achieve team goals while demonstrating organizational values and utilizing resources responsibly. 
• Ability to be proactive and take initiative.
• Exhibit high level of quality through attention to detail and monitoring work.
• Possession of strong organizational skills.
• Excellent verbal and written communication, as well as exceptional interpersonal communication skills. 
• Ability to work independently on assigned tasks, as well as to accept direction on given assignments.
• Deals with confidential information and/or issues using discretion and judgement.

Work Environment & Physical Demands:

Work is performed in an office setting. 

Physical demands of position: sitting, standing, walking, typing, phone communication, face to face conversation.