Prior Authorization/Insurance Specialist

Talley Eye Institute•Evansville, IN

3d•$20 - $21•Onsite

About The Position

This individual is responsible for injection authorization, checking insurance benefits, and out of pocket expenses. The role involves working with retina technicians and physicians to determine appropriate medications, performing thorough benefits investigations, and obtaining prior authorizations for injections by contacting third-party payors. Additionally, the specialist will work directly with patients and staff to enroll them in patient assistance programs and ensure accurate billing for out-of-pocket expenses. The position also includes collaborating with administration and supervisors to improve processes and assist front office personnel and the billing line as needed.

Requirements

High school diploma or equivalent.
Two years minimum experience in medical office, insurance experience preferred.
Excellent communication skills, written and oral.
Strong organization skills with attention to detail.
Excellent follow-up skills.
Management of multiple tasks simultaneously.
Ability to work as a team player.

Nice To Haves

Insurance experience preferred.

Responsibilities

Obtain injection authorizations by contacting third party payors via fax or other approved methods.
Perform a thorough benefits investigation on patients when injections are recommended for treatment.
Work with retina technicians and physicians on determining which medications the patient can have vs. which ones will require a sample or prior authorization.
Work directly with patients and staff to get patients signed up for payment assistance programs.
Enroll patients in assistance programs as needed.
Work with other individuals in RCM department to ensure that patients are not erroneously billed for out-of-pocket expense.
Work with administration and supervisor to look for ways to make processes work more smoothly and reduce the opportunity for errors in the benefits process.
Assist front office personnel as necessary.
Answer billing line when available to help patients with balances and other issues.
Other duties as assigned.