Eligibility and Authorization Specialist
Job Posting for Eligibility and Authorization Specialist at Choice Health Group
Responsibilities
- This role works directly with patients, insurance companies, and clinical departments to verify insurance coverage, obtain proper authorizations.
- Determines deductibles, copayments, coinsurance, CPT and Diagnosis/Procedure Codes, Medical policies, LCD s and Medical terminology.
- Reviews physician orders for medical necessity and accuracy and provides clinical documentation to support proper authorization.
- Provide patient education of service benefits, status of pending or denied authorizations and for limited benefit coverage.
- Accurately enters insurance benefits and authorization information into patient accounts.
- Effectively working with insurance companies, with extensive amount of time on the telephone.
- Provide timely responses to voicemail and email inquiries to the verification team.
- Provide feedback to staff of patient benefits/authorization in a timely manner.
- Assist with submission appeals and follow up with unpaid claims.
- Create patients’ statements.
- Performs other duties as assigned.
Qualifications
- We are looking for an individual with at least 1 year of knowledge and experience in Insurance benefits verification, Authorization requests, and referral requests for Medicare, PPO, HMO, and IPA insurances.
- Positive, caring attitude, and self-motivated to do whatever is necessary to provide.
- Outstanding patient service and do whatever is needed to ensure effective operations.
- Basic level skill in Microsoft Excel, Word, and outlook.
- Can multitask, prioritize, and manage time effectively.
- Have Impeccable attention to detail.
- Enjoys working both independently and collaboratively as part of a team.
- Open to learn and improve skills.
- High school diploma is required.
Salary.com Estimation for Eligibility and Authorization Specialist in Los Angeles, CA
$103,242 to $129,763
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Job openings at Choice Health Group
Choice Health Group
Los Angeles, CA
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