JOB SUMMARY:
Insurance Authorization/Reviewer is responsible for all insurance verification, documentation, obtaining referrals and authorization, notification of benefit and authorization per each insurance provider guidelines
Qualifications
ESSENTIAL FUNCTIONS
o Develops and maintains up to date knowledge of individual insurance program
requirements relative to multispecialty clinic medical services and
Department of Rehabilitation Services.
o Develops strong working relationship with third party payor offices and
physician offices.
o Explains and reviews all insurance requirements with patients to assist them
in understanding the impact of their individual policies on receiving Rehab
services at NWH and are able to successfully obtain all appropriate
paperwork necessary.
o Assists patient in obtaining appropriate paperwork as necessary.
o Obtains and maintains third party payor approval, tracks authorizations and
visits to insure compliance with all third party payor requirements.
SECONDARY RESPONSIBILITIES
o Answers the telephone; takes, screens and relays messages and/or provides
routine information pertinent to operation of Multi-specialty Clinic and
Department of Rehabilitation Services.
o Schedules initial and follow-up appointments for all patients seen in
Department of Rehabilitation Services.
o Transcribes, types, does word processing, data entry, proofreads, corrects,
types and distributes correspondence, reports, patient records and other
materials as necessary for efficient operations.
o Organizes and maintains files, records, logs and other controlling systems;
retrieves files as needed; Communicates needs to health information
services regarding medical records needs for multispecialty clinic and
coordinates activity to assure records available when necessary.
o Sorts, distributes and/or files incoming documents and other
correspondence.
o Reserves rooms and audio visual equipment, as needed.
o Photocopies and releases patient records to third party payors, physicians
and other requesting personnel.
o Greets patients and their families; prepares and assists with all
documentation necessary for completion of chart, insurance
authorization, outcomes analysis and third party payor requirements
for medical specialty clinic and Department of Rehabilitation
Services.
o Prepares documents for treatment and equipment charges to be billed. Does
data entry of charges.
o Reviews copayment information, collects copayments, issues receipts and
maintains appropriate accounting information.
o Performs other duties as assigned.
Subscribe to job alerts and upload your resume!
*By registering with our site, you agree to our
Terms and Privacy Policy.