Pre Authorization Coordinator
Posted on 8/29/2023
Locations
Remote in USA • Chicago, IL, USA
Experience Level
Entry
Junior
Mid
Senior
Expert
Desired Skills
Customer Service
Communications
CategoriesNew
Customer Success & Support
Requirements
- 2+ years of benefit verification and authorization experience strongly preferred
- 3+ years of healthcare front reception billing experience in a fast-paced, customer focused environment, Fertility clinic experience, a plus
- Possess a strong working knowledge of insurance benefits, Managed Care policies
- Strong written and verbal communication skills & a team player
- Willingness to be flexible, roll with the punches, multi-task and troubleshoot problems
- Detail oriented with strong organizational skills
- Exemplifies amazing customer service skills and professionalism
- Medical terminology
Responsibilities
- Verify patient insurance benefits
- Explain insurance coverage and treatment costs and identify the need for any pre-authorizations
- Advise patients of coverage, limitations and exclusions, co-insurance, deductible, special
- Program requirements
- Communicate coverage
- Determine patient responsibility amounts in advance of the related procedures
- Serve as a Patient Advocate for patients when patients have difficulty navigating with their insurance company
- Respond to patient calls/correspondence regarding billing questions, financial policies, claims submission
- Review of medical records for required information related to authorization requirements
- Communicate to clinic about pre authorization requirements and any update any changes
- Update patient accounts, including verification of insurance coverage and changes in patient information, with appropriate documentation
- Respond to a high volume of telephone inquiries in a positive and professional manner, resolve and follow up on all issues within designated timeframes
- Meet positional metrics and benchmarks
- Maintain the highest degree of ethics when handling patient payments and bill processing
- Follow all department standard operating procedures carefully and accurately
- Other duties as assigned by the Director
- Manage inbound customer communication (phone, email & chat) and ensure all messages are answered in a timely fashion
- Maintain clear communication with the clinics about insurance requirements
- Other duties and projects as assigned
Desired Qualifications
- A passion for women's health, fertility is a plus