Insurance Liaison

Sturdy Memorial Hospital•Attleboro, MA

1d•$20 - $30•Onsite

About The Position

Under the general direction of the Clerical Supervisor and within established departmental and hospital guidelines maintains responsibility as liaison between insurance companies and the hospital for prior authorization requests. Extensive involvement with physician offices/staff in order to obtain and provide accurate exchange of information. Maintains hard copy records including periodic purging as required. Responsible for verifying and/or obtaining insurance preauthorization for scheduled outpatient examinations, including website and telephone requests. Keeps up to date on insurance requirements and works with schedulers/technologists to obtain correct authorizations. May be required to complete additional tasks per departmental needs.

Requirements

High School Diploma or equivalent
Minimum of 1 year of experience in customer service industry.
Must be well organized and able to work independently
able to interact in a pleasant manner, either on the telephone or in person with patients and family members
command of verbal and written English
positive interpersonal communication skills
Computer literate
Detail Oriented
Sit for long periods of time, repetitive movements, use of hands to handle, control, or feel objects, tools, or controls.
See details of objects that are less than a few feet away, speak clearly so listeners can understand, understand the speech of another person, use fingers to grasp, move, or assemble very small objects.
Ability to use office equipment such as telephone, computer, scanner, fax machine and copy machine without difficulty.

Nice To Haves

Experience working with Cerner
Experience in a Hospital setting
Medical terminology
Previous experience working with insurance pre-authorizations
Experience with records correspondence
Extensive HIPAA knowledge

Responsibilities

Verify insurance authorization for scheduled exams by using the Internet as well as telephone communication.
Work with schedulers/technologists in verifying correct exam is ordered for presenting problem.
Check prior day’s schedule for additional studies performed that were not authorized.
Contact physician’s office to obtain authorization for additional studies performed – to be done in a timely manner per each insurance filing requirements.
Verify eligibility and pre-authorization requirements for scheduled patients having exams that require prior authorization, especially from offices outside of the health system.
Research and rectify issues presented from coding/billing in regards to prior authorization.
Responsible for general and secondary tasks as needed or assigned.
Maintains hard copy records including periodic purging as required.
Keeps up to date on insurance requirements and works with schedulers/technologists to obtain correct authorizations.
May be required to complete additional tasks per departmental needs.