Medical Billing Eligibility and Authorization Coordinator
About The Position
As an internal and external client-facing professional, the Medical Billing and Eligibility and Authorization Coordinator is a key position in the Revenue Cycle, manages the claims process, including accurate and timely claim creation, follow-up and correspondence with providers, insurance inquiries/correspondence. The incumbent will assist in the clarification and development of process improvements and inquiries, assure payments related to patient services from all sources are recorded and reconciled timely in order to maximize revenues. Other important duties include credentialing, enrollment processing, and reporting for the San Diego Cardiac Center (SDCC).
Requirements
- Answer any questions from management or co-workers with regards to eligibility, authorizations, and referrals procedures
- Obtain authorizations and referrals for office services in a timely manner
- Review appointment books prior to patients coming in to verify patient eligibility with contracted insurance carriers
- Input and verify correct demographic and insurance information for patients
- Notify participating departments in a timely manner when patients' insurance is not contracted with the practice
- Respond to email, EHR messages/tasks throughout the day for all departments
- Serve as backup for team eligibility, referral, and authorization members
- Be a team player: Identify how you might assist fellow team members
- Always represent SDCC and its staff and Providers in a professional, courteous, and respectful manner on or off the property
- Perform other duties as assigned or requested
Responsibilities
- Coordinate the process of patient eligibility through various sources
- Work with reception staff, ensure appropriate collection of copays, spend down and self-pay fees
- Handling inquiries and answers questions from patients, clinic staff and insurance companies
- Identify and resolves patient issues related to referrals, authorizations, and eligibility problems
- Handle eligibility denials with insurance and patients
- Communicate problems to the appropriate Supervisor or Manager
- Maintain strictest confidentiality; adhere to all HIPAA guidelines/regulations
- Other Miscellaneous and Related Tasks
- Answer any questions from management or co-workers with regards to eligibility, authorizations, and referrals procedures
- Obtain authorizations and referrals on office services in a timely manner
- Review appointment books prior to patients coming in to verify patient eligibility with contracted insurance carriers
- Input and verify correct demographic and insurance information for patients
- Notify participating departments in a timely manner when patients insurance is not contracted with practice
- Respond to email, EHR messages/tasks throughout the day for all departments
- Serve as back-up for team eligibility, referral, and authorization members
- Be a team player: Identify how you might assist fellow team members
- Always represent SDCC and its staff and Providers in a professional, courteous, and respectful manner on or off property
- Perform other duties as assigned or requested
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What This Job Offers
Job Type
Full-time
Education Level
No Education Listed
