Insurance Specialist III
Job Description:
• Responsible for obtaining authorizations for elective infusions and injections to financially clear patients and ensure reimbursement for the organization.
• Escalates financial clearance risks as appropriate in compliance with the Financial Clearance Program.
• Serving as a liaison between clinical teams and pharmacists ensuring effective communication regarding infusion prior authorization issues.
• Cases are to be coded, and clinical documentation reviewed to ensure the documentation is complete to maximize reimbursement.
Requirements:
• High school graduate or equivalent with 2 years working experience in a medical environment, OR Associate’s degree and 1 year of experience in a medical environment.
• 3 years’ experience of knowledge and interpretation of medical terminology, ICD-10, and CPT codes.
• Understanding of authorization processes, insurance guidelines, and third-party payors practices.
• Proficiency in Microsoft Office applications.
• Excellent communication and interpersonal skills.
• Ability to prioritize to meet deadlines and multitask a large work volume with a high level of efficiency and attention to detail.
• Basic computer skills.
Benefits:
• Health insurance
• 401(k) retirement plans
• Paid time off
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• Responsible for obtaining authorizations for elective infusions and injections to financially clear patients and ensure reimbursement for the organization.
• Escalates financial clearance risks as appropriate in compliance with the Financial Clearance Program.
• Serving as a liaison between clinical teams and pharmacists ensuring effective communication regarding infusion prior authorization issues.
• Cases are to be coded, and clinical documentation reviewed to ensure the documentation is complete to maximize reimbursement.
Requirements:
• High school graduate or equivalent with 2 years working experience in a medical environment, OR Associate’s degree and 1 year of experience in a medical environment.
• 3 years’ experience of knowledge and interpretation of medical terminology, ICD-10, and CPT codes.
• Understanding of authorization processes, insurance guidelines, and third-party payors practices.
• Proficiency in Microsoft Office applications.
• Excellent communication and interpersonal skills.
• Ability to prioritize to meet deadlines and multitask a large work volume with a high level of efficiency and attention to detail.
• Basic computer skills.
Benefits:
• Health insurance
• 401(k) retirement plans
• Paid time off
Apply tot his job
Apply To this Job