Patient Coverage Coordinator

Medical Oncology Associates of San Diego•San Diego, CA

10d•Hybrid

About The Position

This position is responsible for verifying patient insurance coverage, obtaining authorizations, and assists in resolves billing related issues. This position bridges the gap between patients, medical staff, and insurance companies to ensure care is covered and claims are processed successfully.

Requirements

1 year of recent experience working in a medical office setting with knowledge of office procedures, medical terminology, performing insurance registration, coverage and eligibility verification, and obtaining authorizations.
Knowledge of insurance verification processes
Familiarity with medical coding including CPT and ICD coding standards.
Strong understanding of HIPAA regulations to ensure patient confidentiality at all times.
Ability to multitask efficiently in a fast-paced environment and a capacity to handle high volumes while maintaining attention to detail.
High School Diploma, required
Excellent verbal and written communication skills.
Proficiency in computer processing functions and other standard office equipment.
Ability to effectively manage and prioritize multiple tasks.
Ability to calmly and professionally resolve issues with diplomacy and tact.
Ability to work independently with minimal supervision.
Strong organizational skills.
Visual acuity to read a computer screen and paper documents; close and distance vision, peripheral vision depth perception, ability to adjust focus.
Hearing acuity to converse with staff and customers in person and by phone.
Ability to stoop, bend, kneel, reach with hands, and lift and move 10 pounds on a regular basis, and up to 25 pounds occasionally; ability to sit for hours at a time.

Responsibilities

Verify insurance coverage details using established insurance verification processes.
Update coverage at the account level as necessary to prevent denials.
Completes timely, efficient, verification of coverage and eligibility, and obtains authorizations following payer and internal procedures with minimal supervision.
Manage and track patient office visit authorizations from initiation through completion, ensuring all steps are accurately documented.
Maintain comprehensive medical records, including eligibility and authorization documentation, CPT codes, ICD codes, and other relevant medical terminology.
Ensure compliance with HIPAA regulations by safeguarding patient information during all stages of processing.
Assist in resolving any issues related to insurance coverage denials or on authorization delays promptly and professionally.
Promote a positive, inclusive and supportive team culture across all teams, consistently demonstrating professionalism and integrity.
Continuously identifies issues and trends impacting patient care, quality, and timely reimbursement and reports to leadership along with potential solutions.
Meets quality and productivity standards.