Insurance Verif Auth Team

Chesapeake Regional Healthcare•Virginia Beach, VA

9d•Onsite

About The Position

Under direct and indirect supervision of the Billing/Insurance Manager and/or Executive Director/Outpatient Imaging Administrator, accurately and efficiently verify patient insurance benefits and obtain necessary authorizations and referrals for services rendered at MRI & CT Diagnostics. Confirm deductibles, co-payments, cost-shares, and patient responsibility in a polite and professional manner.

Requirements

High School Diploma
Ability to operate copier, fax machine, and computer
Must have excellent organizational, communication, and interpersonal skills
Ability to set priorities and manage varying workload
Must be able to remain calm in stressful situations
Must display courtesy and empathy toward coworkers and physicians
Must be able to make sound judgments and execute appropriate actions based on knowledge of departmental policies and procedures
Must be discreet with confidential information and abide by corporate HIPAA policies
Must be able to move about freely; sits, stands, and walks intermittently during the day
Must possess sufficient visual and auditory acuity, and manual dexterity to perform tasks
Must attend mandatory practice training and departmental requirements annually

Nice To Haves

Previous healthcare experience preferred
Courses in medical terminology preferred

Responsibilities

Training and Leading New Employees, to Include: Phone etiquette, Navigating the patient system, Navigating websites for authorizations and benefits, Training in how to obtain authorizations and benefits, Calculating copays
Daily operations: Ensuring the employee is able to perform daily Insurance and Authorization job functions, Reporting to the manager on the new employee’s progress
Verify insurance coverage and benefits for all scheduled patients at least 24–48 hours in advance
Confirm accurate billing address of carrier and contact person when appropriate
Confirm patient demographics, referring physician information, and other chart information is accurate
On behalf of the referring physician, obtain authorization for services from the insurance company if required
Process patient and insurance carrier telephone calls
Contact patient and/or referring physician when insurance coverage cannot be verified
Notify patient of any co-payments, cost-shares, or deductibles
Communicate with Scheduling Department when authorization cannot be obtained
Communicate with the front desk regarding any special circumstances
Properly notate accounts of all communications with patients
Ensure that copies of all referrals, written authorizations, and authorization numbers are entered in the patient RIS record and provided to the billing department
Obtain necessary clinical records to facilitate obtaining authorization
Contact attorney, verify representation and billing address, date of accident or injury; instruct front desk personnel to obtain patient signature on lien letter
Review authorization letters for accuracy
Refer patients with special payment circumstances to management
Communicate changes in insurance company requirements with staff and management
Maintain the current exam board as well as the pending board