Insurance Authorization Representative

The Insurance Verification/Payment Specialist is a crucial part of the healthcare team here at Sabates Eye Centers as they are the person responsible for coordinating between the patients' needs and their insurance companies to help ensure the patient is getting the best care available. With the number of patients seen daily at SEC, this position requires the ability to work efficiently in a fast-paced environment.

Responsibilities

• Verify patient insurance eligibility/benefits, acquire pre-determination/prior authorization, confirm facility compatibility

• Document patient benefits and calculate patient out of pocket amounts

• Collection and processing of pre-payments and balances due for procedures.

• Maintain and update insurance policy information in NextGen system.

• Search for, set-up, and maintain third party website access to perform eligibility and verification functions.

• Assist patients with enrolling in copay assistance programs for high-cost medications

• Perform other duties or functions as assigned.

• Maintain the strictest confidentiality in accordance with HIPAA regulations and clinic requirements

Requirements: Education, Experience & Skills

• High school diploma or equivalent required

• 2+ years' experience medical authorizations

• Knowledge and understanding of co-insurance, co-payments, deductibles, and out-of-pockets.

• Comprehensive understanding of insurance verification, contract benefits and medical terminology

• Ability to enter data into various electronic systems while maintaining the integrity and accuracy of the data

• Effective and Efficient A Solving and Analyzing skills

• Professional and calming tone of voice free of use of inappropriate grammar

• Attentive listening skills

• Ability to function effectively under stress of conflicting demands on time and attention, while successfully meeting deadlines

• Ability to clearly articulate a response using appropriate voice modulation

• Strong Verbal and Written skills

• Ability to maintain control of a call de-escalating issues and instilling confidence that a resolution will be found

• Ability to perform essential job function with high degree of independence, flexibility, and creative problem solving techniques

• Excellent organization, time management, and prioritization skills

Physical Requirements:

• While performing the duties of this job, the employee is regularly required to talk and hear.

• The employee is occasionally required to stoop, kneel, crouch or crawl.

• The employee must frequently lift and/or move up to 10 pounds.

• Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.

If you need assistance with this application, please contact (636) 227-2600

EyeCare Partners is an equal opportunity/affirmative action employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status. Please do not contact the office directly - only resumes submitted through this website will be considered.