What are the responsibilities and job description for the Authorization Representative position at Integrated Resources, Inc?
Duties:
Job Summary:
-This position is responsible to obtain insurance eligibility and benefits information and obtain required authorizations.
-Reviews all insurance eligibility responses and communicates with the physician's office and insurance companies as needed regarding these responses or to obtain correct information.
-Works with Utilization Review staff to ensure authorizations cover services needed. May also estimate cost of service and patient's responsibility.
-Refers patients with questionable insurance coverage to the Eligibility Counselors. May assist in mentoring new hires.
Essential Job Duties:
-Obtains insurance eligibility and benefit information using various phone and on-line resources.
-Obtains appropriate authorizations and notifies insurance companies of patient arrival as needed.
-Works with Utilization Review staff and/or physicians' offices to assure eligibility and authorization requirements are completed within the required timeframe.
-Communicates with the appropriate nursing and/or billing staff when changes are made to the account that will affect the reimbursement.
-Makes appropriate corrections in the patient's record to ensure accuracy in order to prevent denials and/or problems with billing and reimbursement.
-Immediately refers "at risk" admission to eligibility, i.e., out of network, underinsured, max benefits, etc.
-Works with insurance eligibility responses and other appropriate reports and works with physicians and patients as needed to resolve issues and prevent billing delays.
-Maintains a satisfactory level of performance and adherence to workload standards.
-Estimates cost of service using ICD-9 or CPT codes.
Performs calculations using insurance benefit information to accurately estimate patient responsibility.
-May lead and/or train new employees in account preparation and review functions.
Skills:
Required Skills & Experience:
-Two years of customer service experience.
-Demonstrated good communications and computer skills.
Physical Requirements:
-Interact with others requiring the employee to communicate information.
-Operate computers and other office equipment requiring the ability to move fingers and hands.
-See and read computer monitors and documents.
-Remain sitting or standing for long periods of time to perform work on a computer, telephone, or other equipment.
Preferred Skills & Experience:
-Demonstrated knowledge of medical terminology.
-Experience in admitting, billing, collections, and/or insurance verification.
-Bi-Lingual Spanish speaking.
-Demonstrated knowledge of CPT/ICD-9 codes.
Shift: Day 8 Schedule Notes: weekend availability
Job Summary:
-This position is responsible to obtain insurance eligibility and benefits information and obtain required authorizations.
-Reviews all insurance eligibility responses and communicates with the physician's office and insurance companies as needed regarding these responses or to obtain correct information.
-Works with Utilization Review staff to ensure authorizations cover services needed. May also estimate cost of service and patient's responsibility.
-Refers patients with questionable insurance coverage to the Eligibility Counselors. May assist in mentoring new hires.
Essential Job Duties:
-Obtains insurance eligibility and benefit information using various phone and on-line resources.
-Obtains appropriate authorizations and notifies insurance companies of patient arrival as needed.
-Works with Utilization Review staff and/or physicians' offices to assure eligibility and authorization requirements are completed within the required timeframe.
-Communicates with the appropriate nursing and/or billing staff when changes are made to the account that will affect the reimbursement.
-Makes appropriate corrections in the patient's record to ensure accuracy in order to prevent denials and/or problems with billing and reimbursement.
-Immediately refers "at risk" admission to eligibility, i.e., out of network, underinsured, max benefits, etc.
-Works with insurance eligibility responses and other appropriate reports and works with physicians and patients as needed to resolve issues and prevent billing delays.
-Maintains a satisfactory level of performance and adherence to workload standards.
-Estimates cost of service using ICD-9 or CPT codes.
Performs calculations using insurance benefit information to accurately estimate patient responsibility.
-May lead and/or train new employees in account preparation and review functions.
Skills:
Required Skills & Experience:
-Two years of customer service experience.
-Demonstrated good communications and computer skills.
Physical Requirements:
-Interact with others requiring the employee to communicate information.
-Operate computers and other office equipment requiring the ability to move fingers and hands.
-See and read computer monitors and documents.
-Remain sitting or standing for long periods of time to perform work on a computer, telephone, or other equipment.
Preferred Skills & Experience:
-Demonstrated knowledge of medical terminology.
-Experience in admitting, billing, collections, and/or insurance verification.
-Bi-Lingual Spanish speaking.
-Demonstrated knowledge of CPT/ICD-9 codes.
Shift: Day 8 Schedule Notes: weekend availability
Salary : $17 - $21
