Eligibility and Authorization Specialist - Los Angeles, United States - Choice Health Group

Choice Health Group
Choice Health Group
Verified Company
Los Angeles, United States

3 weeks ago

Mark Lane

Posted by:

Mark Lane

beBee recruiter
Description

Responsibilities

  • This role works directly with patients, insurance companies, and clinical departments to verify insurance coverage, obtain proper authorizations.
  • Determines deductibles, copayments, coinsurance, CPT and Diagnosis/Procedure Codes, Medical policies, LCD s and Medical terminology.
  • Reviews physician orders for medical necessity and accuracy and provides clinical documentation to support proper authorization.
  • Provide patient education of service benefits, status of pending or denied authorizations and for limited benefit coverage.
  • Accurately enters insurance benefits and authorization information into patient accounts.
  • Effectively working with insurance companies, with extensive amount of time on the telephone.
  • Provide feedback to staff of patient benefits/authorization in a timely manner.
  • Assist with submission appeals and follow up with unpaid claims.
  • Create patients' statements.
  • Performs other duties as assigned.

Qualifications

  • We are looking for an individual with at least 1 year of knowledge and experience in Insurance benefits verification, Authorization requests, and referral requests for Medicare, PPO, HMO, and IPA insurances.
  • Positive, caring attitude, and selfmotivated to do whatever is necessary to provide.
  • Outstanding patient service and do whatever is needed to ensure effective operations.
  • Basic level skill in Microsoft Excel, Word, and outlook.
  • Can multitask, prioritize, and manage time effectively.
  • Have Impeccable attention to detail.
  • Enjoys working both independently and collaboratively as part of a team.
  • Open to learn and improve skills.
  • High school diploma is required.
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