Authorization/Insurance Verification Specialist - Orthopedics Northwest
About The Position
The Authorization/Insurance Verification Specialist is responsible for managing authorizations, insurance and referrals for Multicare Ambulatory providers. Responsibilities include verification of insurance information (eligibility and benefits), referral management, submitting and monitoring of pre-authorizations, determines medical necessity and identifies any coverage concerns and works with providers and billing to resolve authorization denials. Other responsibilities include completing pre-registration as required by patient type and anticipated service. Incumbents work with staff and management throughout the revenue cycle, clinical teams, providers as well as representatives from insurance carriers and government agencies.
Requirements
- Two (2) years of pre-authorization or referral coordinator experience
- OR Two (2) years of experience processing incoming claims or pre-authorization requests for an insurance payor
- OR Two (2) years insurance billing, admitting, or registration experience in a hospital or medical office
- OR Graduate of a health vocational program such as Medical Assistant, or Medical Billing & Insurance, and 1-year experience in healthcare AND Minimum two (2) years of experience in dealing with the public in a customer service role
- Medical Terminology proficiency by examination
Nice To Haves
- One (1) year of post high school business or college course work preferred
- National Association of Healthcare Access Management Certification (NAHAM) preferred
Responsibilities
- Verification of insurance information (eligibility and benefits)
- Referral management
- Submitting and monitoring of pre-authorizations
- Determines medical necessity
- Identifies any coverage concerns
- Works with providers and billing to resolve authorization denials
- Completing pre-registration as required by patient type and anticipated service
Benefits
- Competitive tuition assistance
- Generous PTO
- Code Lavender
- Employee Assistance Programs
- Medical benefits
- Dental benefits
- Retirement benefits
- Paid time off
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
