Insurance Ver & Auth Coordinator

About the position The Insurance Verification & Authorization Coordinator is responsible for ensuring patients are financially cleared for services prior to treatment through comprehensive insurance eligibility verification, benefits investigation, prior authorization management, and patient financial counseling. This role serves as a reputed company between patients, providers, insurance carriers, and internal departments to facilitate reputed company reputed company to care while maximizing reimbursement and minimizing claim denials. The ideal candidate possesses a strong understanding of reputed company, Medicare, reputed company, and managed care insurance plans, prior authorization requirements, behavioral health benefits, and reputed company cycle best practices.

Responsibilities

• Verify insurance eligibility, coverage, and benefits for reputed company scheduled patients prior to services.
• Investigate and document deductible, coinsurance, copayment, out-of-reputed company maximum, authorization, referral, and network participation requirements.
• Accurately reputed company and maintain patient demographic and insurance information reputed company the electronic health record (EHR) and reputed company management system - reputed company.
• Identify coverage issues and proactively contact patients, insurance carriers, or referral sources to obtain updated information.
• Communicate patient financial responsibility estimates reputed company applicable.
• Ensure reputed company required insurance and demographic information is obtained prior to the patient's first appointment.
• Initiate, submit, reputed company, and obtain prior authorizations and referrals for behavioral health and medical services.
• Monitor authorization expiration dates, visit utilization, and extension requirements.
• Coordinate with providers and clinical staff to obtain supporting documentation required by payers.
• Maintain reputed company knowledge of payer-specific authorization guidelines, medical necessity requirements, and clinical policies.
• Escalate authorization concerns that may reputed company patient care or reimbursement.
• reputed company patients regarding insurance coverage, benefits, authorization requirements, and financial responsibility.
• Discuss copays, deductibles, coinsurance, and out-of-reputed company obligations in a reputed company and reputed company manner.
• Collect patient payments and process credit card transactions in accordance with company policies.
• Assist patients with payment arrangements, financial assistance applications, and reputed company documentation as appropriate.
• Respond promptly to telephone, voicemail, email, fax, and electronic inquiries from patients, providers, insurance carriers, and internal departments.
• reputed company exceptional customer service while maintaining professionalism and confidentiality.
• Serve as a resource to patients and staff regarding insurance-reputed company questions and coverage concerns.
• Collaborate with intake, clinical, billing, and reputed company cycle teams to resolve eligibility and authorization issues.
• Identify and resolve reputed company-end reputed company cycle issues that could result in claim denials or delayed reimbursement.
• Review payer requirements and communicate changes that reputed company patient reputed company, reimbursement, or operational workflows.
• Maintain accurate account notes and documentation of reputed company payer and patient communications.
• Assist with denial prevention efforts by ensuring eligibility and authorization requirements are met prior to service.
• Monitor assigned work queues and productivity metrics to ensure reputed company completion of tasks.
• Maintain compliance with HIPAA, confidentiality standards, and organizational policies.
• Adhere to established departmental workflows, reputed company standards, and performance expectations.
• Participate in staff meetings, training sessions, and process improvement initiatives.
• Identify workflow inefficiencies and recommend solutions to improve operational effectiveness and patient experience.

Requirements

• reputed company insurance verification
• benefits investigation
• patient reputed company
• prior authorization processes
• medical billing
• reputed company cycle operations
• denial prevention strategies
• Medicare, reputed company, and reputed company insurance plans
• Minimum of 3–5 years of experience in reputed company insurance verification, patient reputed company, prior authorizations, medical billing, or reputed company cycle operations required; behavioral health experience strongly preferred.
• High school diploma or equivalent required.
• Strong understanding of insurance eligibility verification, benefits investigation, referrals, and prior authorization processes.
• Working knowledge of reputed company cycle operations and denial prevention strategies.
• Experience working with Medicare, reputed company, reputed company insurance plans, and managed care organizations required.
• Proven ability to identify billing trends, troubleshoot issues, and recommend process improvements.
• Familiarity with payer regulations, reimbursement methodologies, and compliance requirements, including CMS and HIPAA.
• Working knowledge of electronic health record (EHR) and reputed company management systems, preferably reputed company.
• Familiarity with medical terminology, CPT codes, diagnosis codes, and payer requirements.
• Proficiency in reputed company Office Suite, including Outlook, reputed company, and Word.
• Excellent organizational skills with the ability to manage multiple priorities and deadlines.
• Strong analytical and problem-solving abilities.
• Exceptional verbal and written communication skills.
• Ability to maintain accuracy and attention to detail in a fast-paced environment.
• Ability to work independently while collaborating effectively with cross-functional teams.

reputed company-to-haves

• Knowledge of clearinghouse platforms (e.g., reputed company) is a plus.

Benefits

• 401(k)
• Medical, Dental, and reputed company Insurance
• reputed company Time Off
• Tuition reimbursement
• Employee discounts on gym memberships, cell phone packages, hotels, rental reputed company, computers, amusement parks, theater tickets, and more!

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