Insurance Verification and Authorization Specialist - Grand Rapids, United States - Infusion Associates

Description

Job Title:
Insurance Verification and Authorization Specialist


Department:
Reimbursement


Location:
Grand Rapids, MI


FLSA Status:
Non-Exempt (Hourly)


Manager Title:
Authorization Manager


About Us

Infusion Associates is multi-specialty infusion provider group with multiple sites across the Midwestern United States and poised for rapid growth.

Our sites support specialty physician services, infusion therapy, and leading
- edge research on new medications for complex and rare disease states. Our service model makes it easy for patients to receive intravenous therapies 365 days a year with the support of physicians, advance practice providers, nursing, and pharmacy services. Our focus is always to provide a high-quality, low cost, exceptional patient experience at every interaction.


Position Summary:

Performs day to day Insurance Verification and Prior Authorization activities to support the Revenue Cycle and to ensure reimbursement for services in a timely and accurate manner.

Essential Functions & Responsibilities

• Verify insurance eligibility and benefits prior to visit.
• Verify coverage of ordered services by calling payers or by obtaining the information using payer portals.
• Verify appropriate reimbursement for ordered services by reviewing payer fee schedule.
• Works with insurance companies to obtain the necessary prior authorizations and/or pre-certifications for services prior to patient visits.
• Maintains current knowledge of payer policies and requirements.
• Provide an accurate estimate of patient's financial responsibility with each order.
• Answers requests from patients, payers and other departments related to coverage of infusion services and prior authorizations.
• Resource to team members and other departments related to insurance benefits and prior authorizations.
• Actively participates in daily team huddles.
• Other duties and projects as assigned.

Knowledge, Skills & Abilities:

1. 2 years related multi-site, multi
- state Revenue Cycle experience and/or training; or equivalent combination of education and experience.

• High School Diploma or equivalent.
• Proficiency in Microsoft Office, including Outlook, Excel, Word, Teams and SharePoint.
• Ability to work efficiently and effectively under tight deadlines and high work volume.
• Knowledge of infusion drugs a plus
• Experience with Veradigm PM and/or Onco EMR a plus.
• Knowledge of medical billing and coding.
• Excellent problem-solving skills.
• Strong analytical, accounting, and mathematical skills.
• Strong, positive interpersonal and communication skills.
• Proficient typing skills.
• Attention to detail is essential in this role.
• Excellent customer service skills

Physical Requirements/Working Conditions:

• Physical Requirement

• Hearing (Frequently)

• Physical Requirement

• Sitting (Frequently)

• Physical Requirement

• Standing (Occasionally)

• Physical Requirement

• Talking (Frequently)

• Physical Requirement

• Walking (Occasionally)

• Physical Requirement

• Near Vision (Constantly)

• Physical Requirement

• Color Discrimination (Frequently)

• Physical Requirement

• Use of keyboard, mouse and/or computer equipment (Constantly)

• Occupational Exposure/Risk Potential

• Inside office environment (Applicable)

• Mental Requirement

• Ability to multitask without loss of efficiency or accuracy, including the ability to perform multiple duties from multiple sources.

• Mental Requirement

• Ability to work and sustain attention with distractions and/or interruptions.

• Mental Requirement

• Ability to interact appropriately with a variety of individuals including customers/clients.

• Mental Requirement

• Ability to understand, remember and follow verbal and written instructions.

• Mental Requirement

• Ability to work effectively and efficiently in high stress and conflict situations.

• Mental Requirement

• Ability to perform under stress and/or in emergencies.

Benefits:

• 401(k)
• 401(k)

matching

• Dental insurance
• Disability insurance
• Employee assistance program
• Health insurance
• Life insurance
• Paid time off
• Retirement plan
• Vision insurance

Weekly day range:

• Monday to Friday

Education:

• High school or equivalent (required)

Experience:

• Insurance verification: 1 year (preferred)

Prior Authorization: 1 year (preferred)

• Knowledge of

Infusion Drugs: 1 year (preferred)

• Allscripts PM: 1 year (preferred)
• Medical Billing or

Prior Authorization: 1 year (required)


Work Location:
In person