Referral & Authorization Coordinator na None
None · West Palm Beach, Estados Unidos Da América · Onsite
- Junior
- Escritório em West Palm Beach
We are looking for a energetic, hard-working, dependable, multi-tasking Medical Insurance Authorization specialists who are passionate about helping others and making a difference.
DUTIES AND RESPONSIBILITIES:
- Verifies information provided by referring physicians and verifies insurance coverage.
- Analyze patient records and insurance policies to determine if procedures, treatments, or medications require prior authorization
- Ensure patients are eligible for services and that insurance benefits are accurate
- Interacts with healthcare providers, insurance companies, and patients to obtain and provide information needed for authorization decisions
- Notify providers of potential coverage options
- Communicate with patients about the authorization process and any potential delays or financial implications.
- May suggest formulary/cheaper alternatives for expensive drugs.
- May investigate any serious drug interactions with the requested drug.
- Completes authorizations and referrals for our medical services, including appointments and procedures.
- Input new patient information and update information in our system
- Compile and submit detailed authorization requests to insurance companies, including all necessary documentation
- Research and resolve any issues or discrepancies related to authorization requests
- Monitor and follow up on authorization requests to ensure timely processing
- Investigate insurance denials and resubmit requests or appeal when necessary.
- Complete billing documentation
- Monitors the schedule for add-on patients, ensuring no conflicts, and we have required prior authorization to move forward with appointment or procedure.
- Remain informed about healthcare industry regulations, trends and insurance policies
- Assist with other clerical tasks as needed and perform other related duties as assigned by management.
QUALIFICATIONS:
- High school diploma or general education degree (GED), or one to three months related experience and/or training, or equivalent combination of education and experience. Associate degree a plus.
- Some experience in medical billing or insurance authorization (strongly preferred).
- Knowledge of medical terminology.
- Basic computer skills.
- Attention to detail.
JOB TYPE / WORK SCHEDULE:
- This is a full-time position, in-office position
- Standard office hours, Monday - Friday 8:00 AM - 4:30 PM
- Bilingual Required
Competitive pay 401(k) Dental Insurance Health insurance Life insurance Vision insurance