The Insurance Authorization Specialist will ensure that insurance benefits are verified, patient responsibility amounts are calculated, and authorizations are obtained on all tests, injections, and procedures prior to the procedure.
- Provide excellent customer service to internal and external customers through prompt response and courteous communication within 24 hours of the request.
- Verify all insurance benefits and eligibility as necessary to ensure accurate financial estimates are provided to the patient and re-verify monthly benefits if the visits spans a new month.
- Assist patients with questions or concerns regarding their authorization, paperwork or payments as needed.
- Obtain authorization on all necessary visits and/or surgical procedures prior to the surgery and/or procedure.
- Ensure all tasking is worked daily and completely to ensure appropriate follow up is timely.
- Interface with physicians and medical staff to ensure all necessary documentation is valid and complete in a timely manner in order to obtain authorizations.
- Respond to and resolve difficult/sensitive inquiries and complaints; evaluate problems and take appropriate action to resolve issues and concerns.
- Immediately alert scheduling and/or Physician/MA team regarding any denial of services.
- Document accurately and timely in the EPM system all authorizations or interactions surrounding the insurance on every patient.
- Responsible for all recertifications