Performs insurance pre-certification against insurance program specifications in a timely manner.
DUTIES AND RESPONSIBILITIES
- Performs insurance/billing clerical duties, including review and verification of patient account information against insurance program specifications.
- Receives and coordinates referrals to include notification of insurance providers for prior authorization and services covered.
- Keeps up to date on billing and pre-certification requirements for each insurance provider.
- Keeps up to date on all billing and benefit changes for third party insurance carriers.
- Secures needed medical documentation required or requested by third party insurers.
- Other duties as assigned.
- Knowledge of general office procedures and equipment.
- Ability to read, write, and speak the English language.
- Ability to manage multiple priorities.
- Must be a good communicator, negotiator – excellent people skills.
- Ability to be compassionate toward patients.
- Ability to maintain confidentiality.
- Ability to work a flexible schedule including evenings and weekends
- High school graduate or GED equivalent.
- Basic computer and word processing software proficiency.
- Must be dependable.
- Maintains operations by following policies and procedures.
- Comprehensive background check including criminal background check, child abuse clearance and credit report.
- MFA personnel
- Health personnel from outside facilities
- Contracted service personnel
- Insurance company representatives
- Patient family members and significant others
In addition to the duties listed above, this position also has physical components as listed below. The list is intended to give an overview of the position as performed by a person without disabilities. In compliance with the Americans with Disabilities Act and the company’s policy on Equal Employment Opportunity, the company will make reasonable accommodations to enable an otherwise qualified individual with a disability to perform the essential functions of the position with or without accommodation where necessary.
- Frequent sitting.
- Frequent operation of keyboard.
- Periodic walking, reaching, and turning.
- Occasional pulling, pushing, lifting and carrying a maximum of 25 lbs.
- Periodic standing, bending, crouching, stooping and kneeling.
- Periodic driving, operating an automobile.