About the Role
Duties & Responsibilities:
Take care of and monitor prior authorization requests.
Record authorization data in accordance with predetermined standards.
Investigate patient accounts for missing or incorrect authorization information, and communicate with customers, insurance providers, patients, and sales reps to get the information required to guarantee accurate, timely, and thorough claim submissions.
Check to see if pre-service criteria and/or prior authorizations have been met.
Determine and report billing and reimbursement trends and prior authorization problems.
After insurance companies deny prior authorization, appeal the decision.
Keep track of all account activity, and react to questions promptly.
While achieving or exceeding all daily, weekly, and monthly output objectives, reviews accounts on a daily basis.
Successfully collaborates and communicates with coworkers from various departments.
Additional corresponding tasks as allocated or called for.
Complete the approval or prior authorization over the phone, online, or by faxing it to the insurance companies.
Verify the patient's insurance eligibility, benefits, and requirements by contacting the insurance companies.
Request, monitor, and secure pre-authorization from insurance providers for lab services within the allotted time frame.
Tracking the status of prior authorizations with insurance companies experience charging for laboratories.
It's important that you are familiar with commercial, Medicare, Medicaid, and insurance companies. The ideal candidate will be motivated by their own objectives and ready to confront problems until they are solved.
Requirements
High school diploma or GED (College degree preferred)
Healthcare industry experience with customer service (preferred)
Strong understanding of Medicare and Medicaid procedures and the ability to manage stress in a fast-paced workplace
Excellent teamwork skills
Medical billing certification an asset
About the Company
Waters Edge Counseling is the largest and fastest growing counseling center in NWA. We are focused on providing quality therapy to the communities that make up NWA and top-notch trainings to counselors.