Retina Financial Counselor

US Eye•Venice, FL

About The Position

The Retina Insurance Coordinator verifies insurance eligibility and benefits for Retina doctors, obtains prior authorization, referral or pre-determination when needed, as well as provides support to patients through patient assistance programs. As needed, the Retina Insurance Coordinator may also be required to perform secondary duties relating to financial counseling, verification and authorization for non-retina specialties.

Requirements

Demonstrated ability to follow oral and written instructions.
Demonstrated knowledge of material, methods, instruments and equipment.
Demonstrated ability to read, write and perform mathematical calculations.
Must be able to maintain high degree of confidentiality.
Ability to multi-task, work in a fast-paced environment and manage time accordingly in order to meet deadlines and requirements of the organization.
A high school graduate or equivalent
Proficient in computer and typing
Knowledge of Microsoft Office products (Word, Excel)
Excellent customer service skills in phone, person or via email
Ability to manage multiple, ongoing tasks while maintaining professional composure
Have an understanding of insurance and medical terminology

Nice To Haves

Bachelor’s Degree

Responsibilities

Verify insurance eligibility and benefits for all Retina Provider appointments to include injections, surgery, procedures, or office visit based upon the type of event scheduled.
Maintaining retina schedule at a minimum of 14 days prior to date of service
Obtain authorization, referral or pre-determination for the retina service that is scheduled.
Patient estimation & pre-service collections, determining out of pocket amount due from patient for the retina service that is scheduled and contacting the patient in advance of the scheduled service to collect the patient responsibility amount.
Notate copays, deductibles, and prior balances to be collected.
Identify patients that may benefit from co-pay assistance and facilitate submission of application and shipping with various funding organizations.
Document insurance eligibility verification and authorization, referral, or pre-determination activities in NextGen appointment details and complete insurance verification templates.
Document patient assistance activities in NextGen tasking.
Monitor services actually performed to identify if a different service was provided, so that an amended or new prior authorization, referral or pre-determination can be obtained.
Answer Financial Counselor queue.
Assist Clinical Teams with same day inquiries.
Adherence to applicable laws, regulations, and contractual obligations.
Follows the principles of the Company’s Compliance Program as well as the Code of Conduct.
Assisting the clinical staff with authorization and balance questions (approval to proceed with same-day drug changes or sample, etc.)
Assisting the clinical staff with Valeda Light Therapy financing options, collecting payments from patients, scheduling patient appointments.
Maintaining primary duties at least 80% of each scheduled day on-site.