Summary

Provides information to patients and maintains good patient rapport. Obtains insurance pre-certifications and verifications and ensure reimbursement from patients or other responsible parties.  Infusion and specialty verification and authorization submission experience is key to this position.

Job Duties

• Financially clears patients for upcoming services
• Responds to and assists physician with patient questions.
• Obtains benefits, creates estimates for patient out of pocket, and submits authorizations for services.
• Follows up on submitted authorizations, notates authorization in appropriate area in Epic for all services. 
• Contacts patient to collect out of pocket expenses. 
• Contacts departments regarding missing clinical information if required by insurance company. 
• Contacts PCP offices to obtain referrals. 
• Understands high level specialty services authorizations.
• Updates referral statuses and collection efforts in Epic. 
• Answers Insurance Verification Helpline and solves insurance issues for patients, physicians, and departments.
• Responds to specific account inquiries by management.
• Creates estimate letters that are electronically forwarded to patients to inform them of their financial responsibility.
• Provides and explains educational material to patients. 
• Investigates insurance coverage and demographics.
• Researches claims denied for no authorization and performs retro authorizations
• Answers phones and provides information to patients or takes detailed messages and routes them to the appropriate party.

Minimum Qualifications

• High school diploma or GED.
• Three years of relevant experience.

Preferred Qualifications

• Epic experience.
• Infusion experience and general specialty services benefits and authorization experience.