Insurance Authorization Specialist

The Insurance Authorization Specialist will work with the Surgical/Referral Coordinators at our referring practice locations to ensure that pre-authorizations are obtained through the patient#s insurance company. This GHS associate will coordinate with the practice locations to collect payments from the patient prior to the scheduled surgery date. Duties Include: # Manage incoming and outgoing calls on a daily basis. # Utilize insurance company websites to obtain pre-authorizations in the most efficient manner. # Maintain accurate pricing, #separately identifying patient portion/insurance portion for surgical procedures performed at the hospital # Communicate to the patient the reason that they are required to make these payments prior to surgery. # Make necessary changes to the patient#s demographics and insurance information to obtain payment from the appropriate insurance company for both primary and secondary coverages. #Accurately document payments in the patient accounts. # Effectively work with Surgical Coordinators at multiple practice locations to overcome any challenges with the patient#s insurance, surgery schedule, and all applicable payments, both patient and insurance, required prior to surgery. # Make corrections as needed to the patient#s electronic record so that future insurance claims and statements are accurate. # Prioritize high volumes of work and make necessary adjustments in daily work activities to keep up with any changes to surgery schedules, and volume changes. # Communicate effectively and accurately any information that impacts the practices ability to collect for services either from the insurance company or the patient.# # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # When needed, will also cross-function as a patient services representative and cashier. # # QUALIFICATIONS# # High school diploma or GED equivalent required. # Experience working in a medical billing environment and prior experience working with insurance companies to obtain pre-authorizations, coding experience preferred.. # Experience communicating with patients about their financial obligations. # Understanding of co-insurance and deductibles. # Excellent time management skills to be able to handle a high volume of both incoming and outgoing calls effectively every day. # Ability to prioritize. # Ability to learn a medical billing system and other related automated systems. Meditech experience preferred but training is provided. #