Insurance Authorization Specialist - Wyomissing, United States - Berks Schuylkill Respiratory Specialists
Description
Summary
Responsible for gathering and maintaining patient demographic and financial information when necessary. Review outstanding Pre-cert requests and ensure authorization is obtained and documented accurately and timely.
Collaborates with physicians, provider office staff, in ascertaining the appropriate authorization based on medical necessity and the treatment plan provided.
Verify/obtain additional clinical information and insurance authorizations/referrals. Communicates direct/indirect with insurance companies to obtain insurance verification and precertification for approval.Job Duties
- Verify eligibility and obtain authorization through telephonic interaction or using an online insurance portal.
- Obtains necessary authorizations in a timely manner
- Liaise with doctor's offices, hospital staff, insurance representatives, Financial Services personnel (PFS) and other departments across the organization to ensure authorization and/or referrals for services on file and accurate with the payer resulting in maximized reimbursement.
- Manages and resolves coverage and authorization issues from intake to final resolution
Job requirements:
- Strong written and verbal communication and organization skills
- Excellent computer skills including Microsoft Office products
- Demonstrates the ability to be self-motivated and prioritize tasks efficiently and accurately
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