Prior Authorization/Insurance Specialist

Talley Eye Institute•Evansville, IN

2d•Onsite

About The Position

This individual is responsible for injection authorization, checking insurance benefits, and out of pocket expenses. The company, Talley Eye Institute, was originally founded as Talley Eye Care by Terry W. Talley, MD in 1972. It has grown to include nine specialists and provides care to patients in three states with eight satellite clinics. Talley has been a trusted and experienced leader in eye care for nearly 50 years and continues to have one of the largest referring networks of optometrists in the region. Talley Eye Institute is dedicated to providing patient-centered, compassionate care with cutting-edge technology using the latest and best techniques, equipment, and trainings to provide the utmost in innovative patient care. All doctors and staff at Talley Eye Institute have a common goal of preserving, enhancing, and maximizing vision, one patient at a time.

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.

Responsibilities

Works with retina technicians and physicians on determining which medications the patient can have vs. which ones will require a sample or prior authorization.
Performs a thorough benefits investigation on patients when injections are recommended for treatment.
Obtain prior authorizations for injections by contacting third party payors via fax or other TEI approved methods.
Heavy phone contact communication.
Work directly with patients and staff to get patients signed up for payment assistance programs, including Good Days, CDF, etc.
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.