Medical Insurance Verification and Prior - Northbrook, United States - USA Clinics Group

USA Clinics Group

Verified Company

Northbrook, United States

3 weeks ago

Posted by:

Mark Lane

beBee recruiter

Description

USA Clinics Group is looking for an organized and motivated individual to join the team as our newest
Insurance Verification/ Prior Authorization Specialist This position performs the function of obtaining referrals, and/or authorizations prior to the service date for test, procedures, and admissions into the clinics.

Responsibilities

Reviews referring physician and patient documentation for Medical Necessity against insurance protocol requirements for precertification purposes.
Actively communicates with staff regarding status of authorization. Communicates the need for reschedule and/or cancellation if authorization not inhand).
Directs liaison to offices and patients regarding new, changed, or pending insurance authorizations, as well as ongoing education of changes in authorization requirements.
Responsible for scheduling STAT, emergent patients for outpatient diagnostic exams.
Interacts with patients, their representatives, physicians, physician office staff, and others to gather and ensure accuracy of demographic, billing and clinical information.
Produces and distributes required forms with accurate patient information.
Respects and protects the patient's rights to confidentiality and privacy and discloses information only for the professional purposes which are in the patient's best interests with full consideration of their legal rights.
Displays a positive attitude when interacting with provider's office staff, providers and fellow employees.
Performs additional duties as assigned