This position works with health insurance providers to determine coverage and benefit limits. This position advises patients of procedure costs and alternative sources of funding and may arrange for referrals or second opinions.
RESPONSIBILITIES AND DUTIES
- Verifies insurance eligibility, documents deductible/co-insurance data in systems
- Obtains authorizations for patient treatments, hospital inpatient/outpatient, any diagnostic tests or injectable drugs and referrals to other physicians
- Conducts Insurance Benefit Reviews with patients including calculating costs of regimens, assuring patient has a clear understanding of their monetary responsibility
- Works with pharmaceutical companies and foundations to obtain grant and financial aid for patients in need
- Coordinates with billing and accounts receivable to collect monetary responsibility from patients at time of service
- Reviews daily schedules and monitors orders in EMR for patients requiring insurance authorizations for follow up visits or treatments
- Tracks and updates authorizations for ongoing office follow ups and treatments
- Inputs authorizations and all changes of patient demographics
- Updates all insurance changes
- Follows up on all pending authorization requests to insurance companies
- Contacts patients with authorization approvals *
- Enters alerts in database and EMR to notify appropriate staff that authorizations are or are not required
Ability to provide excellent customer service. Strong interpersonal and communication skills necessary to deal effectively and sensitively with patients, their families, staff and providers. Excellent organizational and prioritizing skills, must be detail-oriented, with the ability to multi-task. Ability to problem solve, work under pressure and under very tight deadlines. An energetic team player with a positive attitude. Must possess adequate typing skills, familiar with computers, and bi-lingual English with another language is a plus.
EXPERIENCE: Minimum 2-3 Years of work in a health care environment. Extensive patient financial counseling experience is required and knowledge of oncology billing and coding preferred.
EDUCATION: High School Diploma or Equivalent
PHYSICAL DEMANDS: Sit up to 8 hours per day, must be able to lift 10-15 lbs occasionally
WORK ENVIRONMENT: Professional, business setting