Woundlocal
Job Title
Respond to incoming referrals, verify demographic and insurance information, and assess the organization's ability to meet patient needs. Retrieve and secure insurance authorizations and document all interactions per policy. Review authorizations to ensure proper coding (including modifiers) and coverage. Request, track, and obtain pre-authorization from insurance carriers. Collaborate with Billing Department on account updates and authorization activity. Assist with denials by obtaining clinical information, ICD-10 coding, or other details to correct errors. Communicate with referral sources, patients, and internal teams to resolve issues and provide alternative resources when needed. Conduct courtesy follow-ups, participate in training, and ensure compliance with policies and values. Maintain charts, records, and databases of patient authorizations. Stay informed on authorization requirements for all payors and regulatory guidelines.
Respond to incoming referrals, verify demographic and insurance information, and assess the organization's ability to meet patient needs. Retrieve and secure insurance authorizations and document all interactions per policy. Review authorizations to ensure proper coding (including modifiers) and coverage. Request, track, and obtain pre-authorization from insurance carriers. Collaborate with Billing Department on account updates and authorization activity. Assist with denials by obtaining clinical information, ICD-10 coding, or other details to correct errors. Communicate with referral sources, patients, and internal teams to resolve issues and provide alternative resources when needed. Conduct courtesy follow-ups, participate in training, and ensure compliance with policies and values. Maintain charts, records, and databases of patient authorizations. Stay informed on authorization requirements for all payors and regulatory guidelines.