Coordinator Insurance Referral Autho - Naples, United States - NCH Healthcare System

Description

Eastern Time Zone Only

$ hr

ABOUT NCH

NCH is an independent, locally governed non-profit delivering premier comprehensive care. Our healthcare system is comprised of two hospitals, an alliance of 700+ physicians, and medical facilities in dozens of locations throughout Southwest Florida that offer nationally recognized, quality health care.

NCH is transforming into an Advanced Community Healthcare System(TM) and we're proud to: Provide higher acuity care and Centers of Excellence; Offer Graduate Medical Education and fellowships; Have endowed chairs; Conduct research and participate in national clinical trials; and partner with other health market leaders, like Hospital for Special Surgery, Encompass, and ProScan.

Join our mission to help everyone live a longer, happier, healthier life. We are committed to care and believe there's always more at NCH - for you and every person we serve together. Visit to learn more.

JOB SUMMARY

The Coordinator Insurance Referral Authorization provides excellent customer service to all customers through multiple venues, phone, email, and written correspondence. The Coordinator Insurance Referral Authorization will obtain referrals/authorizations utilizing all available tools and resources. Effectively document and communicate referrals/authorizations to the practices in a timely manner through the EHR system. The Coordinator Insurance Referral Authorization will ensure that all referrals and/or authorizations are managed effectively and efficiently for all contracted insurances and organizations.

ESSENTIAL DUTIES AND RESPONSIBILITIES

– Other duties may be assigned.

· Possess vast insurance plan knowledge.

· Ability to interpret and apply policies and procedures.

· Assists with maintenance of internal policies and procedures under Supervisor's direction.

· Communicates with insurance companies to obtain referrals/authorizations via phone, fax, or insurance web portals.

· Follows up on referral/authorization inquiries that have not been immediately resolved.

· Works closely with the practices to ensure patient's referral/authorization is active and correct.

· Ability to verify a patient's eligibility to identify potential eligibility errors prior to the patient's appointment.

· Updates EHR with referral and/or authorization information and acts as a liaison between the practices and billing department.

· Works closely with Revenue Integrity and the RC Billing & Denial Specialists to identify denial trends and assist in resolution.

· Stays current on all insurance changes related to referrals/authorizations.

· Ability to deal with diverse and challenging callers with the philosophy that the customer is always right.

· Protects patient confidentiality by ensuring protected health information (PHI) is secured.

EDUCATION, EXPERIENCE AND QUALIFICATIONS

· Minimum of a High School diploma or GED is required.

· 1-year medical billing experience or PSR experience required.

· Excellent customer service skills.

· Ability to effectively gather and exchange information in both oral and written communications.

· Organizational and time management skills and ability to work independently.

· Proficiency in computer keyboarding skills required.

· Ability to work independently with minimal supervision.

· Detail oriented, analytical skills, ability to problem solve and recommend resolutions.

· Ability to use MS Office Suite (Word, Excel, Outlook).

· Stays current on industry regulations and requirements.