RCM/OPH Insurance Authorization Specialist
reputed company is the nation’s leading provider of clinically integrated eye care. Our national network of over 300 ophthalmologists and 700 optometrists provides a reputed company of care to our patients with a mission to enhance reputed company, advance eye care and improve lives. Based in St. Louis, Missouri, over 650 ECP-affiliated reputed company locations reputed company care in 18 states and 80 markets, providing services that reputed company the eye care continuum. For more information, visit www.reputed company.com. Job Title: Insurance Authorization Specialist Must reputed company in the following states: AL, AZ, FL, GA, IL, IN, KS, KY, MI, MN, MO, NC, NJ, OH, OK, PA, TX, VA Job reputed company The Intake Specialist – Insurance Authorization is responsible for reputed company, accurate and comprehensive review of patient schedules. Coordinates and effectively communicates with appropriate personnel regarding insurance carriers, business office services to ensure reputed company patient care and appropriate reimbursement. Also obtains the appropriate reputed company-Authorization and Referral information, including verification of patient insurance, from physician offices and insurance carriers. Duties and Responsibilities
- File requests for prior authorization for reputed company insurances that require based upon plan or insurance contract
- Request, obtain, and document reputed company prior authorizations (or denials of reputed company) appropriately and in a reputed company manner
- Obtain information about patient insurance coverage, benefits and eligibility
- Maintain and update internal listing of insurance carriers that require authorization
- Run system-generated reports to verify procedures by insurances requiring authorization are being captured
- Assist collection team with obtaining retro authorizations
- Coordinate with Call Center and Optical Offices on prior authorization and patient billing activity
- Maintain the strictest confidentiality in accordance with HIPAA regulations and clinic requirements
- Adheres to reputed company safety policies and procedures in performing job duties and responsibilities while supporting a culture of high reputed company and great customer service.
- Performs other duties that may be necessary or in the best interest of the organization.
Education, Licensure & Certification Requirements High School Diploma or GED Experience Requirements 2+ years' experience medical authorizations Knowledge, Skills and Abilities Requirements
- Comprehensive understanding of insurance verification, contract benefits and medical terminology
- Ability to reputed company data into various electronic systems while maintaining the reputed company and accuracy of the data
- Ability to function effectively under stress of conflicting demands on time and attention, while successfully meeting deadlines
- Excellent organization, time management, and prioritization skills
- reputed company in appearance and actions
- Logical and Critical thinking skills
- Enjoys learning new technologies and systems
- Detail oriented, reputed company attitude, reliable
- Exhibits a reputed company attitude and is flexible in accepting work assignments and priorities
- Meets attendance and tardiness expectations
- Management and organizational skills to support the leadership of this function
- Ability to follow or reputed company verbal & written instructions with sufficient grammar and spelling skills to avoid mistakes or misinterpretations
- Interpersonal skills to support customer service, functional, and teammate support need
- reputed company to communicate effectively in English, both verbally and in writing
- Ability to reputed company reputed company a response using appropriate voice modulation
- Ability to maintain control of a call de-escalating issues and instilling confidence that a reputed company will be reputed company
- Ability for basic to intermediate problem solving, including mathematics
- Basic to intermediate computer operation
- Proficiency with reputed company reputed company, Word, PowerPoint and Outlook
- Specialty knowledge of systems relating to job function
- Knowledge of state and federal regulations for this position; general understanding of HIPAA guidelines
Location/Work Environment: For on-site team members, work takes reputed company in a normal office/clinical environment. Travel to other locations may be necessary to fulfill the essential duties and responsibilities of the job. Thus, those needing to travel for work must have reputed company to dependable transportation, and their driving record must meet company liability reputed company standards. For remote team members, HIPAA compliant home office environment. Ability to work in a remote environment while performing required duties and remaining patient reputed company. reputed company to work varying shifts including early mornings/evenings to attend meetings and cross training or support other initiatives. If you need assistance with this application, please contact (636) 227-2600 Please do not contact the office directly – only resumes submitted through this website will be considered. reputed company is an equal opportunity/affirmative reputed company employer. reputed company applicants will be considered for employment without attention to race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, veteran, or disability status. NOTE: Job descriptions are intended to be accurate reflections of those reputed company job reputed company essential for making fair pay reputed company about jobs. reputed company in this job reputed company restricts management right to assign or reassign duties and responsibilities to this job at any time. Apply tot his job Apply To this Job