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Pre-Authorization Specialist
2 months ago
Company Overview:
Illume Fertility (formerly RMA of CT) specializes in the treatment of infertility, including assisted reproductive technologies (ART) like intrauterine insemination (IUI), in-vitro fertilization (IVF), and pre-implantation genetic testing (PGT). Illume Fertility is Fairfield County’s largest fertility clinic and egg donation center and is led by eight board-certified reproductive endocrinologists. Illume Fertility is consistently recognized as an LGBTQ Healthcare Equality Leader and its Integrated Fertility & Wellness program offers holistic support via acupuncture, mental health counseling, support groups and nutritional counseling. lllume Fertility has 5 convenient locations in Norwalk, Danbury, Stamford and Trumbull, CT and Harrison, NY.
Position Overview:
We are looking for a dedicated Pre-cert specialist to promote Illume Fertility's core values and commitment to teamwork in all endeavors. This role will place a large emphasis on insurance communication for authorization
**This role is remote
Duties and Responsibilities:
- Communicate with insurance companies; Obtain referrals, authorization, pre-determinations
- Data entry of information on approvals/denials into our electronic medical system and or Billing system
- Advise patients of special program requirements for approval of services
- Communicate authorization/pre-determination/referral information with the front desk staff, Clinical staff, RCM department and patient if necessary
- Work in a cohesive way with all departments to promote understanding of insurance policies and regulations, which apply to the authorization process
- Review medical records
- Maintain and protect patient confidentiality
- Perform other assigned tasks and duties as needed
- ·ubmit claims in a timely manner to third party vendors, such as Progyny, Maven, Stork, Winfertility
- Account follow-up on outstanding 3rd party vendor claims as mentioned above
- Correction of claims as required
- Provide reporting of trends on denials or rejections or incorrect payments received with the Director and RCM team
- Other duties as assigned by your manager
Qualifications:
- 2+ years of authorization experience strongly preferred and OR 2+ years of benefit verification experience
- Possess a strong working knowledge of insurance benefits, Managed Care policies
- Knowledge of CPT/and ICD coding a plus
Immunizations:
Staff member must meet immunizations requirements as stated in the Illume Fertility immunization policy.
- TB inoculation
- Flu vaccine
- Others as they become required
Benefits:
- 401(k)
- 401(k) matching
- Dental Insurance
- Employee assistance program
- Employee discount
- Flexible spending account
- Health insurance
- Health savings account
- Life insurance
- Paid time off
- Referral program
- Tuition reimbursement
- Vision insurance
To Learn more about us, please visit our website: Award-Winning Fertility Care in CT & NY | Illume Fertility
Monday-Friday
40 hours/week
