Insurance Verif Auth Team

Under direct and indirect supervision of the Billing/Insurance Manager and/or Executive Director/Outpatient Imaging Administrator, accurately and efficiently verify patient insurance benefits and obtain necessary authorizations and referrals for services rendered at MRI & CT Diagnostics. Confirm deductibles, co-payments, cost-shares, and patient responsibility in a polite and professional manner. ### Major Job Functions #### Training and Leading New Employees, to Include: * Phone etiquette * Navigating the patient system * Navigating websites for authorizations and benefits * Training in how to obtain authorizations and benefits * Calculating copays * Daily operations * Ensuring the employee is able to perform daily Insurance and Authorization job functions * Reporting to the manager on the new employee's progress ### Secondary Job Functions These responsibilities are to be completed as needed and alongside training responsibilities: * Verify insurance coverage and benefits for all scheduled patients at least 24-48 hours in advance * Confirm accurate billing address of carrier and contact person when appropriate * Confirm patient demographics, referring physician information, and other chart information is accurate * On behalf of the referring physician, obtain authorization for services from the insurance company if required * Process patient and insurance carrier telephone calls * Contact patient and/or referring physician when insurance coverage cannot be verified * Notify patient of any co-payments, cost-shares, or deductibles * Communicate with Scheduling Department when authorization cannot be obtained * Communicate with the front desk regarding any special circumstances * Properly notate accounts of all communications with patients * Ensure that copies of all referrals, written authorizations, and authorization numbers are entered in the patient RIS record and provided to the billing department * Obtain necessary clinical records to facilitate obtaining authorization * Contact attorney, verify representation and billing address, date of accident or injury; instruct front desk personnel to obtain patient signature on lien letter * Review authorization letters for accuracy * Refer patients with special payment circumstances to management * Communicate changes in insurance company requirements with staff and management * Maintain the current exam board as well as the pending board ### Qualifications * High School Diploma * Previous healthcare experience preferred; courses in medical terminology preferred * Ability to operate copier, fax machine, and computer * Must have excellent organizational, communication, and interpersonal skills * Ability to set priorities and manage varying workload ### Specifications * Must be able to remain calm in stressful situations * Must display courtesy and empathy toward coworkers and physicians * Must be able to make sound judgments and execute appropriate actions based on knowledge of departmental policies and procedures * Must be discreet with confidential information and abide by corporate HIPAA policies * Must be able to move about freely; sits, stands, and walks intermittently during the day * Must possess sufficient visual and auditory acuity, and manual dexterity to perform tasks * Must attend mandatory practice training and departmental requirements annually * Works in a clean, well-lit medical facility; subject to electrical, chemical, magnetic, and radiant energy hazards; exposure to infectious disease and lifting hazards; must stoop and bend in the course of job performance