Advanced Urology Snellville , GA 30078
Posted 1 week ago
Position Description: Performs various access-related duties to include but not limited to, eligibility/insurance verification for services , obtaining authorization/referrals , scheduling, canceling, rescheduling, point of service payments, general appointment information and directions.
Reports to: Revenue Cycle Supervisor
MISSION
Provide strong and exceptional customer service skills and ability to follow policies regarding insurance verification. Authorizes and pre-certifies services by coordinating and performing activities required for verification and authorization of insurance benefits for services and communicate the patients financial responsibility. Proactively identifies resources for patients and may communicate the financial resources available to patients whose health plan does not include coverage for services. Ensure the patients confidentiality and integrity are maintained to the highest standards.
OUTCOMES
Interviews patients and/or family members as needed to secure information concerning insurance coverage, eligibility, and qualification for various financial programs.
Coordinates and performs verification of insurance benefits for every visit by contacting insurance company /website and determining eligibility of coverage and communicates status of verification/authorization/referral process with appropriate team members in a timely and efficient manner
Provides clinical information as needed, emphasizing medical justification for procedure/service to insurance companies for completion ofauthorization/referral process.
Acts as a liaison between clinical staff, patients, physician,insurance payor, external vendors (ex: drug reps, pharmacy, ) forming patients of referral or authorization/benefit delays/denials, answering questions, educating patients about their benefit, and offering assistance.
Maintains tracking of patients on schedule, ensuring that the correct insurance plan, eligibility,referral and authorization information has been entered into data entry systems accurately along with documenting applicable notes or review secure notes.
Calculate estimated patient responsibility to inform the patient and document in the data entry system.
Adhere to the Collections Policy to ensure patients are aware that payment is due at time of service and responsible for setting up payment arrangements.
Collect payment prior to or on the date of service.
Reschedule/cancel patients in the data entry system accordingly due to verification/authorization related issues
COMPETENCIES
Job Related Competencies:
Ensures Accountability: Holding self and others accountable to meet commitments.
Action Oriented: Taking on new opportunities and tough challenges with a sense of urgency, high energy, and enthusiasm.
Manages Conflict: Handling conflict situations effectively, with a minimum of noise lens.
Interpersonal Savvy: Relating openly and comfortably with diverse groups of people.
Drive Results: Consistently achieving result, even under tough circumstances.
Cultural Competencies:
Advanced Values:
People
Collaborates: Building partnerships and working collaboratively with others to meet shared objectives
Heart
Patient Focus: Building strong patient relationships and delivering patient centric solutions
Service
Instills Trust: Gaining the confidence and trust of others through honesty, integrity, and authenticity
Excellence
Cultivates Innovation: Creating new and better ways for the organization to be successful
Behaviors:
Being Resilient:
Rebounding from setback and adversity when facing difficult situations
Self-Development:
Actively seeking new ways to grow and be challenged using both formal and informal development challenges
Optimizes Work Processes:
Knowing the most effective and efficient processes to get things done, with a focus on continuous improvement
Professional Communication:
Developing and delivering multi-mode communications that convey a clear understanding of the unique needs of different audiences, while maintaining a professional appearance and tone
QUALIFICATIONS
Basic Qualifications:
Education:
Previous, Job Relevant Work Experience:
2 years of experience in insurance verification, financial counseling, billing, scheduling, equivalent externship, or access related position
Working knowledge of basic medical terminology
Ability to work independently in a changing environment and handle stressful situations.
Must be able to speak and write in a clear and concise manner to convey messages and ensure that the customer understands whether clinical or non-clinical
Proficient in Microsoft Word/Excel/Outlook, and insurance websites
May require travel within Metro Atlanta as needed
Demonstrate a high level of professional conduct with colleagues, superiors, and internal/external customers.
Attend mandatory meetings/training in office when necessary.
Advanced Urology