- Trains, coaches, and leads the authorization team; monitors and evaluates work; and reports any issues to the manager.
- Verify patient benefits and calculate out-of-pocket costs using multiple insurance resources.
- Obtain, review, and input insurance authorization and referrals before patient services.
- Monitor and track patient authorizations
- Be proficient in the use of ICD-10 and CPT codes.
- Verifies the status of participating providers and insurance plans.
- Supports medical office team members.
- Works closely with the management team in the business office to ensure all internal and external customer service
- Participates in educational activities and leads/attends team staff meetings
- Maintains insurance company reference materials
- Analysis of pre-determination of benefit estimates vs actual
- Surgery collection & authorization review
- Coordinates the authorization team work schedules and effectively manages time-off requests ensuring adequate coverage at all times.
- Review/update/approve time cards in the timekeeping system for the authorization team
- Performs other duties as required and takes on additional special projects as assigned.
Authorizations Team Lead - Fort Myers, United States - Riverchase Dermatology
Description
Riverchase Dermatology, an AQUA Dermatology portfolio practice, is Florida's largest and most comprehensive full-service skin care provider in the Southeast, offering medical, surgical, and cosmetic dermatology, plastic surgery, vein care, and radiation care with over 100 locations throughout Alabama, Florida, and Georgia.
Our established practices and experienced physicians offer patients the highest quality outcomes and an exceptional patient experience.From common rashes to skin cancer treatments, and plastic surgery procedures to an array of vein treatments, no case is beyond our knowledge and expertise.
We are seeing an Authorization Team Lead who provides support for verifying current and accurate patient insurance information and works with insurance companies to obtain authorization (s) for services.
ESSENTIAL FUNCTIONS
We offer competitive salaries and benefits:
Medical, Dental, and Vision available after 30 days of hire
Short-term disability and life insurance, and many ancillary options.
401k available after 90 days of hire
Excellent growth and advancement opportunities
Discounts on employee products and services
POSITION TYPE AND EXPECTED HOURS OF WORK
Full-Time
Monday - Friday
There is a possibility of working from home 3 days a week after 90 days of employment.
TRAVEL
Travel is not expected for this position.
SUPERVISORY RESPONSIBILITY
This position holds no formal supervisory authority; however, the Lead Authorization Specialist does serve as a coach and mentor to authorization specialist staff
QUALIFICATIONS
Education - Associate's Degree preferred or high school graduate, GED/equivalent. Certificate from a technical school for
billing a plus
Experience - Medical office experience; dermatology and plastic surgery preferred. Knowledge of HIPAA regulations, insurance payers, ICD-10 and CPT codes, and fee schedule reimbursement methodology. 3 years of experience in a medical office or central billing office performing revenue cycle functions
Communication - Excellent verbal and written communication skills.
Work Style - Must be able to work well independently but ask for help when needed. Ability to analyze and interpret information, ability to interact and decipher information telephonically and electronically.
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Founded in 1998, AQUA Dermatology is the Southeast's premier dermatology practice with over 100 locations throughout Alabama, Florida, and Georgia.