GENERAL SUMMARY OF DUTIES: Performs general business office functions that may include some or all of the following: insurance verification and eligibility; insurance pre-authorization/pre-certifications; counseling patients and families on insurance and financial responsibility prior to surgery. Ensures all insurance, demographic, and eligibility information is obtained from physician office or patients and entered into the billing system in an accurate and timely manner. Collects and revises all patient insurance information. Collects co-pays, deductibles and other out of pocket amounts at the time of service. Balances receipts, reconciles daily work batches and prepares audit trail.
PRIMARY RESPONSIBILITIES:
Ensure all records are maintained in absolute integrity and in compliance with applicable regulations and requirements.
Obtaining required referrals and authorizations via phone, fax, on-line, etc.
Review reports daily for patients requiring authorizations, pre-notification, and insurance benefit verification.
Obtaining retro-authorizations or updating existing authorizations in a timely manner.
Data entry in a fast-paced environment with high expectation on accuracy.
Updates the patient account with details of the insurance verification.
Coordinating with patients regarding their insurance benefits.
Identifies deductibles, co-pays, and self-pay accounts.
Notifying the appropriate staff members if treatment or service is denied.
Re-verify patients monthly for active, current insurance.
Assist manager and other staff with account questions when presented.
Perform other duties as assigned.
Relies on experience and judgment to plan and accomplish goals.
REQUIREMENTS:
High School diploma or equivalent.
1-2 years experience in healthcare insurance billing and verification, collections and/or authorizations.
Knowledge of medical terminology.
Knowledge of insurance contracts and utilization.
Knowledge of CPT/ICD-10
Knowledge of deductibles, co-pays, and co-insurance.
Knowledge of computer systems, programs and spreadsheet applications.
Skills in written and verbal communication and customer relations.
Ogden, Utah
Full Time