21 Feb

Pre Certification And Insurance Specialist Jobs Vacancy in Midwest Eye Consultants Kokomo

Position
Pre Certification And Insurance Specialist
Company
Midwest Eye Consultants
Location
Kokomo IN
Opening
21 Feb, 2018 30+ days ago

Midwest Eye Consultants Kokomo urgently required following position for Pre Certification And Insurance Specialist. Please read this job advertisement carefully before apply. There are some qualifications, experience and skills requirement that the employers require. Does your career history fit these requirements? Ensure you understand the role you are applying for and that it is suited to your skills and qualifications.

Follow the online directions, complete all the necessary fields, and provide all relevant information so your application is submitted correctly. When you click the 'Apply this Job' button (open in new window) you will be taken to the online application form. Here you will be asked to provide personal and contact details, respond to employment-related questions, and show how you meet the key selection criteria.

Pre Certification And Insurance Specialist Jobs Vacancy in Midwest Eye Consultants Kokomo Jobs Details:

POSITION SUMMARY: The Pre-Certification and Insurance Specialist ensure that all patient insurance is verified as active, any pre-certifications and or referrals are obtained, and both office staff and patients are made aware of responsible balances due.

ESSENTIAL RESPONSIBILITIES:

  • Develops effective relationships with insurance company representatives.
  • Utilize ICD-9 and CPT codes to ensure proper authorization for procedure and claims payment.
  • Responsible for explaining benefits, the billing process and financial responsibilities to patients.
  • Responsible for obtaining complete and accurate insurance information, benefit verification, accurately interpreting benefit plans and investigating pertinent details. Notifies supervisor of know or potential issues.
  • Responsible for obtaining and communication pre-authorization as needed per insurance company requirements.
  • Responsible for obtaining and communicating all Primary Care Physicians referrals as required per insurance.
  • Responsible for tracking, obtaining and extending authorizations from various carriers ina timely manner.
  • Record insurance information to maintain data through the Referral/Insurance Verification process and communicates insurance information to pertinent staff.
  • Independently works from the Eyecare database, Availity, CSnap and other electronic resources.
  • Track a significant amount of data and information, preparing and producing meaningful information.
  • Provides detailed, accurate and current clinical information to insurance representatives.
  • Follow up on requests for authorization for service on unpaid claims as requested by Central Billing.
  • Maintain a strong working knowledge of precertification and referral requirements by insurance carrier.
  • Perform any other related duties as directed by the immediate supervisor

EDUCATION AND/OR EXPERIENCE:

  • High School diploma or equivalent
  • Minimum of one (1) year experience in the role of Pre-Certification and Insurance Specialist, Intake Representative, Insurance Representative, or Prior Authorization Representative or related field in a healthcare setting.


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