¿ Three (3) years of experience working in a medical practice or in a health insurance organization
¿ Excellent verbal and written communication skills
¿ Previous experience with precertification and prior authorizations with third parties
¿ Processes and maintains third party referral information and coordinates referral procedures with clinical units and billing
¿ Review office notes and procedures to ensure coding is accurate
¿ Processes all requests for copies of medical records and disability forms and coordinates completion of forms with clinical units, medical records and billing for all offices.
¿ Maintains and updates records request and forms request logs
¿ Answer hospital consult line, collect information, follow established protocol of handling.
¿ Willing to travel to other COUG locations for business needs
¿ Assists with check-in and check-out of patients when coverage is needed
¿ Maintains strictest confidentiality
¿ Performs related work as required
¿ Coordinates authorizations with third parties and ensures medications are ordered for patient treatments
¿ Interfaces with billing for coding and authorization corrections
¿ Posts all charges and payments in the practice management system and verifies and prepares bank deposit daily
¿ Verifies eligibility and coordinates office and hospital procedures for proper pre-certification/authorization with third parties
¿ Maintains files for contacts and phone numbers for third party communication for all offices
¿ Manage reports to track unbilled charges or deficiencies
¿ Handles problem referrals with third party and coordinates solution with clinical unit, patient and referral provider
A little about us:
We partner with people to improve skills, teams and lives every day, and we help them achieve more than they ever thought possible.