Preauthorization Representative - NHMP Danbury Rheumatology - Danbury, CT
Nuvance Health Med Practice CT, Danbury, CT, United States
At Nuvance Health, we enjoy the benefits of a two-state system as we cultivate an inclusive culture where everyone feels welcomed, respected and supported. Together, we are a team of 15,000+ strong hearts and open minds. If you share our values of connected, personal, agile and imaginative, we invite you to discover what’s possible for you and your career.
When you join our growing, multi-specialty medical practice, you can enjoy the advantages of being a part of a large health system while working in a more intimate setting than a hospital. You can build relationships with patients over time as you take advantage of opportunities for more team building, socialization and work-life balance.
We offer a range of outpatient practices, including primary care, oncology, neurology, gastroenterology, endocrinology, OB/GYN, bariatric, surgical, cardiology and infectious diseases. Join the Nuvance Health medical practice and be part of a collaborative team in an environment of open communication and unwavering compassion.
Title:
Preauthorization Representative - NHMP Danbury Rheumatology - Danbury, CT. Full time, 40 hours per week, 8‑hour shifts 8:30am - 5:00pm, Monday - Friday.
Summary:
Facilitates patient flow through the pre‑registration process, including scheduling, prior authorization, benefits investigation and financial clearance for NHMP medical practice medications. Answers incoming phone calls in a timely manner with excellent customer service to patients and referring physicians. Responsible for obtaining demographic and financial information to ensure accurate patient identification, identify, and secure appropriate payment sources. Performs pre‑registration functions and insurance eligibility verification.
Responsibilities
Serves as the coordinator for prior authorization of all in‑office medications and infusions as directed by clinicians.
May be assigned to register, schedule patients and answer all incoming phone calls in a timely manner. Provides excellent customer service to both physicians and patients.
Serves as a liaison with clinicians, scheduling and clinical staff regarding patient authorizations.
Communicates with insurance providers about the patient's medical necessity and obtains authorization for needed authorizations.
Ensures that proper selection of insurance, plan type, prioritization, pre‑certification and billing address are assigned in the system utilizing a broad knowledge of insurance as well as regulatory and contractual compliance.
Responsible for the collection of co‑payments and past‑due balances when necessary.
Facilitates in gathering accurate patient billing information.
Performs insurance eligibility verification and executes payer requirements as needed. Includes initiating eligibility transactions via the Internet, contacting the payer to obtain billing information and authorization and scripts for service when appropriate.
Initiates requests for authorizations, prior authorizations, and referrals from insurance companies. Utilizes Electronic Medical Record (EMR) system to obtain necessary clinical information to secure such prior authorization. Follows up with payers to ensure that authorizations are in place prior to time of service. Takes appropriate steps to remediate situations in which financial clearance is not completed prior to time of service to ensure that WCHN (hospitals and medical group) receive prompt payment for services rendered.
Responds to telephone calls according to established customer service standards. Provides requested information to callers. May initiate contact to patients to obtain additional information or confirm scheduled appointments.
Fulfills all compliance responsibilities related to the position.
Maintains and models Nuvance Health Foundational Values (Personal, Imaginative, Agile, Connected).
Performs other duties as required.
Other Information Required:
High School Diploma/GED, Data entry, MS Word and MS Excel required.
Minimum Experience:
seven years or more.
Salary Range:
$18.13 - $34.50 hourly (Pay per years of relative experience).
With strong hearts and open minds, we’re pushing past boundaries and challenging the expected, all in the name of possibility. We are neighbors caring for neighbors, working together as partners in health to improve the lives of the people we serve. If you share our passion for the health of our communities, advance your career with Nuvance Health!
#J-18808-Ljbffr
When you join our growing, multi-specialty medical practice, you can enjoy the advantages of being a part of a large health system while working in a more intimate setting than a hospital. You can build relationships with patients over time as you take advantage of opportunities for more team building, socialization and work-life balance.
We offer a range of outpatient practices, including primary care, oncology, neurology, gastroenterology, endocrinology, OB/GYN, bariatric, surgical, cardiology and infectious diseases. Join the Nuvance Health medical practice and be part of a collaborative team in an environment of open communication and unwavering compassion.
Title:
Preauthorization Representative - NHMP Danbury Rheumatology - Danbury, CT. Full time, 40 hours per week, 8‑hour shifts 8:30am - 5:00pm, Monday - Friday.
Summary:
Facilitates patient flow through the pre‑registration process, including scheduling, prior authorization, benefits investigation and financial clearance for NHMP medical practice medications. Answers incoming phone calls in a timely manner with excellent customer service to patients and referring physicians. Responsible for obtaining demographic and financial information to ensure accurate patient identification, identify, and secure appropriate payment sources. Performs pre‑registration functions and insurance eligibility verification.
Responsibilities
Serves as the coordinator for prior authorization of all in‑office medications and infusions as directed by clinicians.
May be assigned to register, schedule patients and answer all incoming phone calls in a timely manner. Provides excellent customer service to both physicians and patients.
Serves as a liaison with clinicians, scheduling and clinical staff regarding patient authorizations.
Communicates with insurance providers about the patient's medical necessity and obtains authorization for needed authorizations.
Ensures that proper selection of insurance, plan type, prioritization, pre‑certification and billing address are assigned in the system utilizing a broad knowledge of insurance as well as regulatory and contractual compliance.
Responsible for the collection of co‑payments and past‑due balances when necessary.
Facilitates in gathering accurate patient billing information.
Performs insurance eligibility verification and executes payer requirements as needed. Includes initiating eligibility transactions via the Internet, contacting the payer to obtain billing information and authorization and scripts for service when appropriate.
Initiates requests for authorizations, prior authorizations, and referrals from insurance companies. Utilizes Electronic Medical Record (EMR) system to obtain necessary clinical information to secure such prior authorization. Follows up with payers to ensure that authorizations are in place prior to time of service. Takes appropriate steps to remediate situations in which financial clearance is not completed prior to time of service to ensure that WCHN (hospitals and medical group) receive prompt payment for services rendered.
Responds to telephone calls according to established customer service standards. Provides requested information to callers. May initiate contact to patients to obtain additional information or confirm scheduled appointments.
Fulfills all compliance responsibilities related to the position.
Maintains and models Nuvance Health Foundational Values (Personal, Imaginative, Agile, Connected).
Performs other duties as required.
Other Information Required:
High School Diploma/GED, Data entry, MS Word and MS Excel required.
Minimum Experience:
seven years or more.
Salary Range:
$18.13 - $34.50 hourly (Pay per years of relative experience).
With strong hearts and open minds, we’re pushing past boundaries and challenging the expected, all in the name of possibility. We are neighbors caring for neighbors, working together as partners in health to improve the lives of the people we serve. If you share our passion for the health of our communities, advance your career with Nuvance Health!
#J-18808-Ljbffr