Insurance Verification & Authorization Agent

Optimus Health Care, Inc. • Stamford, CT

8d • Hybrid

About The Position

Optimus Health Care is looking for a Part-Time Insurance Verification & Authorization Specialist to join our Behavioral Health department in Stamford, CT location (covering other sites as needed). The Insurance Verification & Authorization Agent is a member of our BH care team responsible for working with Providers, Nurses, and Clinical Support staff to ensure a complete and timely insurance and authorization flow process. Assure that pre-work is performed before the patient arrives by verifying demographic and insurance information to ensure prompt payment of services to Optimus. This position will contact patient’s insurance company to verify coverage levels and works with patients to walk them through their benefits information. The position works to ensure that patients have been authorized for specialty services and office visits. May act as a liaison between the patient, provider/referring provider, BH provider, and other parties involved in the plan of care. Appropriately link referrals for identified visits.

Requirements

• Great computer skills.
• Commitment to maintenance of patient privacy
• Flexibility to work at other OHC sites as necessary.
• High School diploma/GED
• five years experience preferred, preferably in a health care setting.

Nice To Haves

• Associates degree preferred.
• Familiarity with EMR, helpful.
• Bi-lingual Helpful

Responsibilities

• Responsible and accountable for verification of insurances to ensure billing of services.
• Review appointment schedules to identify insurance for verification, with particular insurance plans.
• Verify insurance coverage, copays and deductibles through employer, insurance carrier, and/or on line verification including the amounts “met to date” and any pre-authorization requirements.
• Verify coordinate of benefits in using the “birthday rule”, if patient is a minor.
• Update patient notes in the system with pertinent insurance changes or concerns, as a means to ensure account history is available for respective departments.
• Works closely and assists the Practice Manager with related special projects as necessary, including billing participation in performance improvement initiatives
• If patient qualifies for entitlement refer (by task) to FCC.
• Responsible to communicate with patient on insurance coverage concerns and any additional information required by carrier to process payment.
• Perform other related duties as required.

What This Job Offers

• Job Type: Part-time
• Career Level: Entry Level
• Education Level: High school or GED