What are the responsibilities and job description for the Eligibility and Prior Authorizations Specialist position at DERMATOLOGY INC?
Dermatology, Inc. was founded in 1968 and has grown into one of the largest dermatology practices in the Midwest, providing comprehensive medical, surgical, and cosmetic skin care to meet the needs of our patients. We have eleven board certified physicians and nine allied health professionals. We have expanded to several locations throughout Indianapolis and the surrounding areas. We are looking for a qualified individual to join our team.
We are seeking a positive and self-motivated team player with the ability to perform in a fast-paced environment. The ideal candidate will have a friendly and professional personality and the ability to prioritize a variety of tasks simultaneously.
Key responsibilities include but are not limited to:
The Eligibility and Prior Authorizations Specialist is tasked with verification of eligibility and coverage with health insurance carriers using our practice management eligibility tool, payer websites or by calling the insurance companies.
When appropriate verify and confirm correct coordination of benefits with the patients and insurance companies.
Identify plans that have referral requirements and obtain the referral.
Utilize Microsoft Teams to communicate with other departments.
Submit prior authorizations for procedures performed in the office and document patient accounts accordingly.
Explain billing statements to patients/responsible party.
Collecting and posting payments from patients.
Answer incoming calls and resolve patient/insurance inquiries.
Other related tasks as required.
This is an onsite job, not remote.
Requirements:A minimum of two years of experience working with insurance verification within a medical practice.
Has a good understanding of EOB/ERA data as well as insurance benefits and eligibility.
Basic knowledge of Commercial and Government insurance carriers.
Previous experience with TriZetto and Modernizing Medicine preferred.
Requires good listening, interpersonal and communication skills, and professional, pleasant and respectful telephone etiquette.
Demonstrates ability to manage multiple, changing priorities in an effective and organized manner.
Excellent data entry, numeric, typing and computer navigational skills.
