What are the responsibilities and job description for the Pre-Authorization Insurance Representative position at Elevate ENT Partners?
Welcome to Texas Ear, Nose & Throat Specialists! We are one of the premier ENT specialty groups on the Texas Gulf Coast and are dedicated to providing our patients with total care for diseases and disorders of the head and neck. We offer the highest level of specialty care for all ear, nose and throat problems at our many convenient offices in Harris and the surrounding counties. With more than 30 board-certified Otolaryngologists in 17 locations spanning four counties, we offer excellent, top-rated service and care right in your community.
We focus on providing the most up-to-date treatment combined with the best in customer service for our patients with hearing problems, allergies, dizziness, sinus infections, snoring or any other ear, nose and throat related problems. Texas ENT Specialists also offers specialized divisions including the Texas Facial Plastic Surgery Center, the Texas Ear Center, and the Texas Center for Voice and Swallowing.
Texas E.N.T. Specialists offers a fast-paced, enriching work environment and an excellent compensation and benefits package (competitive salary, medical, dental, vision, long-term disability, life insurance, FSA, HSA, matching 401k and tuition reimbursement program).
The Patient Insurance Representative is responsible for creating a positive patient and provider experience by accurately and timely handling the day to day operations related to financial clearance. These responsibilities include but are not limited to: reviewing documentation for payer-specific guidelines, verification of benefits, pre-authorization requirements, and determining patient financial obligations for surgical services.
Key Functions
We focus on providing the most up-to-date treatment combined with the best in customer service for our patients with hearing problems, allergies, dizziness, sinus infections, snoring or any other ear, nose and throat related problems. Texas ENT Specialists also offers specialized divisions including the Texas Facial Plastic Surgery Center, the Texas Ear Center, and the Texas Center for Voice and Swallowing.
Texas E.N.T. Specialists offers a fast-paced, enriching work environment and an excellent compensation and benefits package (competitive salary, medical, dental, vision, long-term disability, life insurance, FSA, HSA, matching 401k and tuition reimbursement program).
The Patient Insurance Representative is responsible for creating a positive patient and provider experience by accurately and timely handling the day to day operations related to financial clearance. These responsibilities include but are not limited to: reviewing documentation for payer-specific guidelines, verification of benefits, pre-authorization requirements, and determining patient financial obligations for surgical services.
Key Functions
- Reviews medical policies to ensure documentation guidelines are met
- Obtains and documents verification of patient benefits to include network participation status, patient out-of-pocket expenses, exclusions, and lifetime max
- Obtains pre-authorizations timely and documents reference/authorization numbers
- Provides financial counseling to patients to include cost estimates, payment terms, collection of payment, and any barriers related to financial clearance
- Works collaboratively with providers, clinic staff, and the CBO team to ensure all financial clearance requirements are met
- Responsible for escalating financial clearance issues to the Supervisor for timely resolution
- Accurately documents all communication
- Conducts all activities in alignment with TENTS core values
- Completes all extra projects as assigned
- High school diploma or equivalent required
- Three years of experience in healthcare, insurance, or related field preferred.
- Experience with computer-based software (eClinicalWorks experience preferred in addition to Microsoft Word and Excel)
- Ability to type 35 words per minute
