Company:
Hollis Cobb Associates
Location: Duluth
Closing Date: 07/11/2024
Hours: Full Time
Type: Permanent
Job Requirements / Description
About this Position:
- Contacts insurance companies and other third-party payers to determine Pre-Authorization requirements for basic and moderately complex outpatient hospital services.
- Calls insurance companies or uses online tools to obtain pre-authorization and/or referral prior to service date. Follows-up timely and thoroughly.
- Ensures all pre-authorization issues are communicated in a timely manner.
- Liaisons with physician's staff to obtain additional insurance and/or clinical information.
- Confirms eligibility, coverage, and benefits with insurance companies. Determines financial responsibility for service.
- Reviews patients' charts for clinical justifying medical necessity for the service.
- Follows up properly on all denials and peer-to-peer requests.
- Researches and assists with denied pre-authorization or pre-determinations.
- Documents appropriately regarding all actions, authorization, referral details, and referral modifications for specialty care and testing for patients with insurance plans requiring formal referral documentation.
- Formidable knowledge of copay's, deductibles, co-insurance for In-network & out-of-network medical benefits.
- Able to prioritize, work accurately, work well independently, and able to maintain focus under pressure.
- Working knowledge of medical terminology, insurance packages/plans, and proficiency with EMR.
- Strong knowledge of government payers. Claim status follow-up is a plus.
- Clearly communicate with providers, insurance companies, staff, and patients.
- Excellent verbal and written communication skills.
- Excellent organizational skills, Multi-tasking capabilities, and detail orientated.
- Customer Services skills with heavy phone contact and client interface.
- Basic Computer/PC and Internet skills.
- Working with MS office products/ Excel and Word.
- Attention to detail and problem-solving skills.
- Must be a great team player and passionate about working.
- Medical
- Health Savings Account for High Deductible Medical plan
- Dental
- Vision
- Life Insurance
- Disability Insurance
- Retirement with Company Matching
- Paid Time Off & Holidays
- Employee Assistance Program
- Referral Program
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Hollis Cobb Associates