What are the responsibilities and job description for the Insurance Verification / Prior Authorization Representative position at Rezolut?
Job Description
Job Description
Job Summary :
The Pre-Certification Representative is responsible for obtaining approval from insurance companies for services that require referral, pre-certification or prior authorization.
Essential Functions
- Maintains patient demographic information and data collection systems.
- Verify insurance eligibility for both medical and vision insurances for upcoming appointments by utilizing online websites or by contacting the carriers directly.
- Review patient deductibles and / or copays and enter into the billing system and spreadsheets provided to the front-end department at all locations.
- Coordinate with front end regarding scheduling errors.
- Assist front end staff and call center staff in understanding carrier websites and verification of eligibility.
- Enter insurance referrals as needed.
- Broad understanding of insurance company requirements related to services that require referral, pre-certification or prior authorization required.
- Participates in development of organization procedures and update of forms and manuals.
- Answers questions from patients, clerical staff and insurance companies.
- Works in conjunction with the reception to ensure clean billing.
- Performs miscellaneous job-related duties as assigned.
- Participates in educational activities and attends monthly staff meetings.
- Maintains strictest confidentiality; adheres to all HIPAA guidelines / regulations.
- Assists in development and communication of SOP for key areas to improve accuracy and understanding of processes.
Qualifications / Skills :
What We Offer :
Who is Rezolut?
Rezolut is a national emerging platform of diagnostic medical imaging services. With focus on four key platforms, our vision is to provide topnotch patient care partnered with innovative technology — to achieve better health outcomes. We provide high-quality, cost-effective, fixed-site outpatient diagnostic imaging as well as mobile imaging and health services. In each of our regions, we are the best in radiology, offering all radiology services!
