Pre Authorization Coordinator
Posted on 8/29/2023

501-1,000 employees

Remote in USA • Chicago, IL, USA
Experience Level
Desired Skills
Customer Service
Customer Success & Support
  • 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
  • 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