Eligibility and Authorization

Overview

Schedule hospital procedures and obtain referrals for Cardiology practice. The Eligibility and Authorization role is crucial in ensuring that patients receive the necessary approvals for their medical services. This position involves working closely with healthcare providers, insurance companies, and patients to verify eligibility and obtain authorizations for treatments. The ideal candidate will have a strong understanding of medical coding, terminology, and insurance processes, particularly in a cardiology medical office setting.

Responsibilities

• Verify patient eligibility for insurance coverage and benefits prior to treatment.
• Obtain prior authorizations from insurance companies for various medical procedures and services.
• Maintain accurate records of all communications with insurance providers and patients regarding eligibility and authorization status.
• Collaborate with healthcare providers to gather necessary documentation for authorization requests.
• Ensure compliance with relevant regulations and policies related to patient information and insurance verification.
• Update and manage patient records in accordance with ICD-9 and ICD-10 coding standards.
• Provide support to the medical office team by answering questions related to eligibility and authorization processes.
• Multi-task role . Front office skills also required. Scheduling , answering phones, admitting and exiting patients in a busy cardiology practice.

Skills

• Proficiency in medical coding, including familiarity with ICD-9 and ICD-10 codes.
• Strong understanding of medical terminology and procedures within a dental or medical office context.
• Experience with insurance verification processes, including knowledge of various insurance plans.
• Excellent organizational skills with attention to detail in managing patient records.
• Ability to communicate effectively with patients, healthcare providers, and insurance representatives.
• Proficient in using office software applications relevant to the role, such as electronic health record (EHR) systems.

This position is ideal for individuals who are detail-oriented, possess strong communication skills, and are committed to providing excellent support within a healthcare environment.

Job Type: Full-time

Expected hours: 40 per week

Benefits:

• 401(k)
• Health insurance
• Paid time off

Ability to Commute:

• Downey, CA 90241 (Required)

Ability to Relocate:

• Downey, CA 90241: Relocate before starting work (Required)

Work Location: In person