Employment Opportunities

General Description

Responsibilities & Duties

• Coordination of resources, including primary and secondary third party payers.
• Obtains precertification and prior authorization of required medical services from third party payers.
• Maintaining a professional and confidential working environment.
• Explain insurance benefits, policy requirements, and filing rules to patients.
• Research and apply knowledge of all insurance rules and regulations for major insurance programs in the local or regional area.
• Enter patient data into appropriate database and update and maintain accurate files.
• Ensure client confidentiality and compliance with HIPAA regulations.
• Determine the protocol that identifies a responsible party’s monetary responsibility in health insurance claims.
• Verify all patients insurances.
• Obtain Authorizations as required by insurance carriers.
• Collect all Co-pays, Coinsurance and Deductibles.
• Other duties as assigned.

Qualifications

• High School Diploma or GED.
• At least three years of medical office experience with a Certificate in Medical Coding and Billing or a Certified Medical Reimbursement Specialist.
• Experience in working with third-party resources such as Medicare, Medicaid and Private Insurance, Contract Health or Coordination of Benefits, medical records, reception and patient registration a must.
• Knowledge of billing procedures and insurance verification.
• Knowledge of medical terminology and medical insurance claims processing.
• Knowledge of medical software is a must to access and interpret patient data.
• Must be computer literate.
• Must possess the ability to communicate effectively verbally and written.
• Must be self-motivated and have the ability to prioritize work tasks with good organizational skills.
• Must have excellent customer service skills.
• Must have a valid driver’s license.
• Must be able to pass a background check and drug screen.