Prior Authorization/Insurance Specialist

Talley Eye Institute•Evansville, IN

9d•$20 - $21

About The Position

The Insurance Specialist works in the Billing department and reports to the Revenue Cycle Manager. The role is responsible for injection authorizations, insurance-benefit checks, and out-of-pocket expense review. The specialist works with retina technicians, physicians, patients, and staff to determine medication coverage, investigate benefits, obtain prior authorizations, and connect patients with payment assistance programs. The position also supports billing and front-office operations and helps improve benefits-process accuracy and efficiency.

Requirements

High school diploma or equivalent.
At least two years of experience in a medical office.
Excellent written and oral communication skills.
Strong organizational skills and attention to detail.
Excellent follow-up skills.
Ability to manage multiple tasks simultaneously.
Ability to work as a team player.

Nice To Haves

Insurance experience preferred.

Responsibilities

Work with retina technicians and physicians to determine which medications patients can receive and which require a sample or prior authorization.
Perform thorough benefits investigations when injections are recommended for treatment.
Obtain injection prior authorizations when needed by contacting third-party payors by fax or other approved methods.
Communicate extensively by phone.
Work with patients and staff to enroll patients in payment assistance programs, including Good Days and CDF.
Coordinate with others in the Revenue Cycle Management department to help prevent patients from being incorrectly billed for out-of-pocket expenses.
Work with administration and the supervisor to improve processes and reduce errors in benefits processing.
Assist front-office personnel as necessary.
Answer the billing line when available to help patients with balances and other issues.
Perform other duties as assigned.