Job Description

JOB DUTIES

   This position reports to the Billing Manager and is generally responsible for ensuring patients insurance eligibility also that referrals,               pre-certifications and authorizations for procedures, are obtained prior to appointments.  ·      

    INSURANCE VERIFICATION

·         For all patient appointments, verify insurance coverage via telephone or internet and ascertain co-pay, deductible and coinsurance amounts due from patients, at least four business days before appointment.

·         Perform insurance pre-certification for procedures at least one week before appointment.

·         Enter insurance information and all pre-certification approvals received, in the patient’s EMR chart prior to the day of the appointment.

·   COORDINATING PATIENT REFERRALS

·         Ascertain need for a referral from a PCP (primary care physician) or other referral source.

·         Visit the insurance web-site to obtain referral documents.

·         Advise patient and referring doctor’s office staff of need for referral if not found on web-site.

·         Review referral to ensure proper format and correctness and enter into patient’s chart in the EMR system.

·         Ensure all referrals in place two business days prior to appointment, otherwise call patient to reschedule appointment.

QUALIFICATIONS

·         High school graduate or equivalent. Knowledge of medical terminology and experience with EMR systems Highly desirable.

·         Prior medical insurance-related experience such as verification of insurance coverage essential.

·         Good interpersonal skills for handling telephone and patient contact.

·         Ability to multi-task with good organizational skills.

·         Ability to act effectively under pressure.

Company Description

Established Gastroenterology medical practice in the Decatur area