Reauthorization Specialist
VieMed Healthcare, Lafayette, LA, United States
DUTIES
Review and obtain necessary compliant documentation, medical records and prescriptions in order to submit for prior authorization with insurance.
Responsible for obtaining prior authorization from insurance payor for durable medical equipment.
Verify patient demographic and health insurance information to review and work pending tasks daily for authorizations and/or appeals.
Notify RT/Sales management teams regarding non‑compliance and authorization deadlines that are not met.
Establish and maintain effective communication and good working relationships with patients/family, physicians’ offices, and other internal teams for the patient’s benefit.
Perform other clerical tasks as needed, such as: Answering patient/Insurance calls
Faxing and emailing
Communicate appropriately and clearly to Manager/Supervisor and other superiors. Report all concerns or issues directly to Revenue Cycle Manager and Supervisor.
Other responsibilities and projects as assigned.
REQUIREMENTS
High School Diploma or equivalent.
Learn and maintain knowledge of current patient database and billing system.
Verify insurance for all products.
Understand insurance benefit breakdown of deductibles and co‑insurance.
Understand insurance medical and payment policies.
Knowledge of Explanation of Benefits from insurance companies.
General knowledge of government, regulatory billing and compliance regulations/policies for Medicare & Medicaid.
Working knowledge of CPT and ICD‑10 codes, HCFA 1500, UB‑04 claim forms, HIPAA, billing and insurance regulations, medical terminology, insurance benefits.
Enough knowledge of policies and procedures to accurately answer questions from internal and external customers.
Utilize initiative while maintaining set levels of productivity with consistent accuracy.
EXPERIENCE
2‑4 Years in DME or Medical Office experience preferred.
Minimum of 1 year of insurance verification or authorizations required.
SKILLS
Superior organizational skills.
Proficient in Microsoft Office, including Outlook, Word, and Excel.
Attention to detail and accuracy.
Effective/professional communication skills (written and oral)
#J-18808-Ljbffr
Review and obtain necessary compliant documentation, medical records and prescriptions in order to submit for prior authorization with insurance.
Responsible for obtaining prior authorization from insurance payor for durable medical equipment.
Verify patient demographic and health insurance information to review and work pending tasks daily for authorizations and/or appeals.
Notify RT/Sales management teams regarding non‑compliance and authorization deadlines that are not met.
Establish and maintain effective communication and good working relationships with patients/family, physicians’ offices, and other internal teams for the patient’s benefit.
Perform other clerical tasks as needed, such as: Answering patient/Insurance calls
Faxing and emailing
Communicate appropriately and clearly to Manager/Supervisor and other superiors. Report all concerns or issues directly to Revenue Cycle Manager and Supervisor.
Other responsibilities and projects as assigned.
REQUIREMENTS
High School Diploma or equivalent.
Learn and maintain knowledge of current patient database and billing system.
Verify insurance for all products.
Understand insurance benefit breakdown of deductibles and co‑insurance.
Understand insurance medical and payment policies.
Knowledge of Explanation of Benefits from insurance companies.
General knowledge of government, regulatory billing and compliance regulations/policies for Medicare & Medicaid.
Working knowledge of CPT and ICD‑10 codes, HCFA 1500, UB‑04 claim forms, HIPAA, billing and insurance regulations, medical terminology, insurance benefits.
Enough knowledge of policies and procedures to accurately answer questions from internal and external customers.
Utilize initiative while maintaining set levels of productivity with consistent accuracy.
EXPERIENCE
2‑4 Years in DME or Medical Office experience preferred.
Minimum of 1 year of insurance verification or authorizations required.
SKILLS
Superior organizational skills.
Proficient in Microsoft Office, including Outlook, Word, and Excel.
Attention to detail and accuracy.
Effective/professional communication skills (written and oral)
#J-18808-Ljbffr