What are the responsibilities and job description for the INSURANCE COORDINATOR position at Biospine Holding Company, LLC?
Job Description
Job Description
JOB TYPE :
Insurance Coordinator
HOME COMPANY : Gulf Coast Spine
REPORTS TO :
Billing Office Manager
FLSA STATUS : Non-Exempt
PRE-REQUISITE : none
UPDATED / REVIEWED : 3 / 25 / 2024
SCOPE OF RESPONSIBILITIES
A nonexempt position responsible for Insurance Coordinator.
ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. While this is intended to be an accurate reflection of the current job, management reserves the right to revise the job or to require that other or different functions be performed when circumstances change or exigencies require (this includes but is not limited to emergencies, changes in personnel, workload, rush jobs, or technological developments).
- Review of payer coverage determinations and submission of surgical procedures authorizations.
- Interpretation and review of patient insurance benefits as it relates to booked surgeries.
- Works in collaboration with clinical staff to ensure that all medical necessity criteria are met and documented in the proper locations of the patient chart.
- Will act as a liaison to the billing department to ensure that any post-surgical payment issues are resolved timely.
- Works with patients to ensure that any potential financial obstacles are addressed, including determining patient eligibility for financial assistance, payment plans, or Care Credit application.
- Understands payer policy for all government and commercial insurances.
- Utilizes online resources to identify updates and changes in policy.
- Research exceptions and determine the appropriate resolution.
- Communicate with Billing Department Management, payor organizations and other relevant parties to ensure timely resolution of exception items.
- Achieve and maintain performance consistent with requirements for productivity, quality, and service levels.
- Develop and maintain productive team-oriented relationships through individual contacts and group meetings.
- Communicates with other team members in clinical and clerical areas to provide a successful patient centered practice.
- Other duties as assigned.
NTIA s may be assigned.
EDUCATIONAL REQUIREMENTS
EXPERIENCE / OTHER REQUIREMENTS
KNOWLEDGE
SKILLS & ABILITIES
Abilities :
PHYSICAL DEMANDS
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
Combination of standing, sitting, bending, and reaching. May work at computer monitors for prolonged periods of time using fingers to keyboard, handle or feel. Workload will be heavy at times.
WORK ENVIRONMENT
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.
Medical exam and treatment rooms and medical offices. Environment setting (lighting, temperature, air quality, acoustics) controlled. Well-lighted, well-ventilated adequate space.
