Insurance Authorization Representative - Milwaukee, United States - ALWs Consulting

ALWs Consulting

Verified Company

Milwaukee, United States

3 weeks ago

Posted by:

Mark Lane

beBee recruiter

Description

Maintains, confirms and secures referrals. authorization, or pre-certifications required for patients to receive physician or medical services. Verifies the accuracy and completeness of patient account information. Maintains database of payer authorization requirements.

Responsibilities:

Contacts insurance carriers to obtain benefit coverage, policy limitations, authorization/notification, and precertifications for patients. Follows up with physician offices, financial counselors, patients and thirdparty payers to complete the precertification process.
Collaborates with intersal departments to provide account status updates, coordinate the resolution of issues, and appeal denied authorizations.
Educates patients, staff and providers regarding referral and authonzation requirements, payer coverage, eligibility guidelines, documentation requirements, and insurance related changes or trends.
Ensures all services have prior authorizations and updates patients on their preauthorization status. Coordinates peer to peer review if required by insurance.
Notifies patient accounts staff/patients of insurance coverage lapses, and selfpay patient status. May notify ordering providers if authorization/certification is denied.
May coordinate scheduling of patient appointments, diagnostic and/or specialty appointments, tests and/or procedures.
Maintains Fles for referral and insurance information, and enters referrals into the system, Maintains knowledge of, and reference materials of the following Medicare, Medicaid and thirdparty payer requirements, guidelines and policies, insurance plans requiring pre

- authorization and a list of current accepted insurance plans.

Education Required:

High School Graduate.

Experience Required.

Typically requires 1 year of experience in providing customer service that includes experiences in patient accounts, thirdparty payer plans, accounts receivable/collection processes, and medical clinic processes and workflow.

Knowledge, Skills & Abilities Required:

Knowledge of thirdparty payers and preauthorization requirements.
Intermediate computer skills including use of Microsoft Office (Excel and Word), electronic

- mail, physician practice management, and electronic medical records systems.

Strong analytical, prioritization and organizational skills.
Ability to work independently with mínimal supervision and to manage multiple priorities.
Exceptional communication and interpersonal skills with a high degree of diplomacy and tact. Ability to effectively communicate with a variety of people under stressful circumstances.

Physical Requirements and Working Conditions:

Exposed to a normal medical office environment.
Sits the majority of the workday.
Operates all equipment necessary to perform the job.

Job Types:
Full-time, Contract

Pay:
$ $31.00 per hour

Benefits:

Dental insurance
Health insurance
Paid time off

Weekly day range:

Monday to Friday

Application Question(s):

Do you have experience in providing customer service that includes experiences in patient accounts and medical clinic processes and workflow?
Do you have experience of thirdparty payers and preauthorization requirements ?
Do you have understanding of basic human anatomy ?

Education: