Description:
About the Job
Ascend Vision Partners is a rapidly growing ophthalmology management group expanding throughout the Southeastern United States. We are looking for candidates to join our team of dedicated professionals who are excited to work for a company that is expanding quickly.
Reporting to the Senior Billing Manager, the Verification and Authorization Specialist will have prior medical insurance experience. He or she must possess the desire to learn and grow with a company that is rapidly expanding.
Responsibilities:
Maintains patient demographic information and data collection systems.
Verify insurance eligibility for both medical and vision insurances for upcoming appointments by utilizing online websites or by contacting the carriers directly.
Obtain referrals from the PCP or authorizations from the insurance prior to the upcoming appointment.
Consistently communicate with the patient on the status of the referral or authorization prior to the appointment.
Review patient deductibles and/or copays and document in notes sections as well as the pop-ups in the billing system.
Assist front desk staff and call center staff in understanding verification of eligibility or status of the referral and/or the authorization.
Verify accuracy of referral / authorization and enter in to Managed Visits.
Participate in development of organization procedures and update of forms and manuals.
Answers questions from patients, clerical staff, and insurance companies.
Works in conjunction with the front desk staff and surgical schedulers to ensure clean billing.
Manage and utilize time effectively, assist others within the department, to ensure department meets required service levels.
Alert management to irregularities, patient trends and areas of concern.
Maintain communication with direct manager and promptly follow-up with other departments as needed especially when seeking further information.
Performs miscellaneous job-related duties as assigned.
Participates in educational activities and attends staff meetings.
Maintains strict confidentiality; adheres to all HIPAA guidelines/regulations.
Assists in development and communication for key areas to improve accuracy and understanding of processes.
Requirements:
Qualifications:
Minimum of 1-year relevant experience and/or training, or equivalent combination of education and experience.
Proficient in computers and relevant software applications and practice management technology.
Possession of strong problem-solving skills and sound judgement.
Ability to collaborate across departments and build effective relationships with internal and external customers to achieve goals.
Knowledge of customer service principles and practices.
Ability to achieve team goals while demonstrating organizational values and utilizing resources responsibly.
Ability to be proactive and take initiative.
Exhibit high level of quality through attention to detail and monitoring work.
Possession of strong organizational skills.
Excellent verbal and written communication, as well as exceptional interpersonal communication skills.
Ability to work independently on assigned tasks, as well as to accept direction on given assignments.
Deals with confidential information and/or issues using discretion and judgement.
Preferred Experience:
Prior insurance verification and authorization experience in a medical office.
Customer service.
Work Environment & Physical Demands:
Work is performed in an office setting.
Physical demands of position: sitting, standing, walking, typing, phone communication, face to face conversation.