What are the responsibilities and job description for the Medical Insurance Specialist position at DCH Health System?
Overview
Obtains precertification, authorization or referral from insurance companies for patients receiving care in the Cancer Center. Records all precertifications, authorizations, and referrals in the appropriate software system. Coordinates with clinicians and clerical staff regarding any issues regarding patient insurance status.
Responsibilities
DCH Standards:
- Maintains performance, patient and employee satisfaction and financial standards as outlined in the performance evaluation.
- Performs compliance requirements as outlined in the Employee Handbook
- Must adhere to the DCH Behavioral Standards including creating positive relationships with patients/families, coworkers, colleagues and with self.
- Performs essential job functions in a manner that ensures the safety of patients, visitors and employees.
- Identifies and reduces unsafe practices that may result in harm to patients, visitors and employees.
- Recognizes and takes appropriate action to reduce risks and hazards to promote safety for patients, visitors and employees.
- Requires use of electronic mail, time and attendance software, learning management software and intranet.
- Must adhere to all DCH Health System policies and procedures.
- All other duties as assigned.
Qualifications
Must be a High school graduate. Healthcare experience required, with minimum of 2 years of Oncology experience preferred. Clerical skills with demonstrated proficiency in keyboarding/computer use. Must be self-motivated and possess the ability to work effectively in an independent environment. Ability to work well with the public, physicians, insurance companies and other hospital staff in a courteous and professional manner. Must be able to read, write legibly, speak, and comprehend English. Experience with obtaining preauthorization and working with insurance companies preferred. Knowledge of medical terminology preferred.
WORKING CONDITIONS
WORK CONTEXT
Frequent interaction with others, in person or by telephone, including those that may be discourteous or unpleasant in content. . Extensive use of computers and computer systems Extensive documentation requirements requiring attention to detail.
PHYSICAL
Perform light work with minimal force exerted.
Talking, hearing, bending ,walking, lifting, repetitive motion, standing, and/or using hands to handle, control, or feel objects, tools or controls. Light work. Exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly to move objects.
Must be able to perform the duties with or without reasonable accommodation.
Hearing and vision must be normal or corrected to within normal range.
Physical presence onsite is essential.
