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Position Summary: The Workers Comp / Insurance Verification and Precertification Specialist is responsible for the verification of all patients benefits and authorizations prior to Surgery. MUST HAVE EXTENSIVE EXPERIENCE WITH WORKER'S COMPENSATION VERIFICATION / AUTHORIZATION PROCESSES as well as all Insurance benefits and procedures that are verified utilizing on-line insurance website resources as well as outbound phone calls to insurance companies. This position also obtains any demographic or insurance information required to verify the insurance. Once the insurance has been confirmed active, benefits are documented in the scheduling system and an active surgical appointment is booked with necessary notes regarding collections of deposits, etc.

Reports to: Director of Business Office

Flexibility: While this job description is meant to provide an overview and specific responsibilities of the Insurance Verification, Benefits, & Authorization Coordinator, JASC Management reserves the right to make changes, adjustments and revisions, as needed, to this document and will coordinate such modifications with JASC's Practice Administrator and Billing Office Directors.

Summary of General Duties:

*** Extensive communication with worker's compensation adjustors obtaining billing and authorization information.

• Contact various insurance companies either by phone or on-line website to obtain insurance benefits.
• Contact patient or surgeon's office to obtain information necessary to verify insurance.
• Verify insurance is accurate, updated and active.
• Verify insurance eligibility and benefits for copay, deductible and coinsurance for outpatient surgery procedures.
• Scan or fax approved scheduling request to surgeons offices.
• Obtains pre-certification/pre-authorization from insurance companies for Outpatient Surgical procedures. Confirms insurance companies are in-network. If not, then contacts patient to discuss and make alternate arrangements as necessary per policy guidelines.
• Communicates with the patient on their benefit information.
• Document accounts in the scheduling system via the Registration Information Notes with benefit information or special instructions for Business Office.
• Update insurance and demographics in scheduling system.
• Research enrollment issues due to lack of information or incorrect information.
• Complete all task within the timelines established by the facility.
• Answers the telephone in a warm, friendly manner.
• Maintains patient confidentiality.
• Perform other duties as assigned or requested.
• Completes mandatory continuing education assigned by Manager and Facility Administrator annually.

Working Environment:

Physical demands:

Ability to grasp with both hands; pinch with thumb or forefinger; turn with hand/arm; reach for (above shoulder height)

Ability to type 60 wpm.

Ability to operate multi-line telephone system, computer keyboard and ten-key adding machine.

• Visual, Hearing, and Mental demands: Vision adequate to perform essential functions such as read telephone displays/computer terminals for long periods of time, correctable to 20/20. Hearing adequate to perform essential functions such as answering the telephone. Mental capacity adequate to perform essential functions such as quickly and accurately entering patient demographics and scanning documents while checking in multiple patients. Tact to deal with unfriendly individuals regarding various situations, and adequately handle stress.
• Working Conditions: Normal business office environment. Requires individual to be in uniform daily. Required to exhibit a positive attitude and a professional appearance and show great detail and accuracy. Required to exhibit quality performance of the essential job functions to help the office run effectively and efficiently.

Position Requirements:

• High School education or GED equivalent.
• Minimum five years of medical office experience.
• Minimun of five years of health insurance experience REQUIRED.
• Must have working knowledge of medical terminology with ICD-10 & CPT coding knowledge. ALL OTHERS NEED NOT APPLY. THIS POSITION IS FOR AN EXPERIENCED INSURANCE / WORKERS COMP SPECIALIST ONLY.
• Working knowledge of general office duties.
• Working knowledge of insurance verification process.
• Working knowledge of contracted insurance plans.
• Good verbal and written communication skills.
• Excellent telephone skills.
• Demonstrated ability to use a computer with Microsoft Word, Outlook and EMR software.
• Excellent customer service skills.
• Strong organizational skills with the ability to multi-task.
• Ability to maintain confidentiality and thorough knowledge of HIPAA policies and procedures.

Benefit Conditions:

• Waiting period may apply
• Only full-time employees eligible

Work Remotely

• No

Job Type: Full-time

Pay: From $16.00 per hour

Expected hours: 40 per week

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Schedule:

• Monday to Friday
• No weekends

Education:

• High school or equivalent (Required)

Experience:

• Medical Office: 5 years (Required)
• ICD10 & CPT Coding: 5 years (Required)
• Insurance Verification: 5 years (Required)

Work Location: In person