Insurance Coordinator

4 weeks ago


Great Neck, United States Retina Long Island ASO, LLC Full time

Vitreoretinal Consultants of NY is the premier retinal care destination for patients across Long Island, Queens, NYC, and beyond. Founded in 1981, our team of nationally-recognized retina specialists and surgeons have established themselves as distinguished physicians, compassionate providers, and key thought leaders in the retina care community. We are committed to providing a compassionate and ethical environment that focuses on patient-centered care. From diagnostics to clinical trials, we bring clarity, transparency, and humanity to all aspects of what we do. We have a very high level of patient satisfaction and are proud of our reputation, online and in the medical community. Job Purpose: To verify eligibility of insurance, to confirm plan coverage for various office visits, medical procedures and treatments of patients to ensure timely payment of such visits. Advises physicians of any insurance/managed care constraints. Assists patients in obtaining funding through Chronic Disease Fund or Genentech Access to Care Foundation. Obtains or advises patients the need for proper referrals. Duties: Verifies insurance/managed care plans for eligibility for all of the insurance plans listed in the patient account. Uses Athena to confirm eligibility and/or contacts the payer directly and documents the outcome in the patient account. Contacts patients directly when insurance has terminated or shows ineligible in attempts to obtain new information prior to office visits. Will pre-certify all patient testing, procedures and injections by confirming their insurance/managed care plan eligibility in addition to confirming whether prior authorization for visits and treatments are necessary. Advises both physician and patient of insurance findings and benefit investigations, discusses the possibility of supplemental funding through Chronic Disease Fund and Access to Care Foundation Will assist patients with the proper forms necessary for CDF and GATCF and confirm when funding is in place. Provides the proper clinical documentation to the foundations as needed. Obtains and/or advises patients of the need for referrals as indicated on their insurance plan, i.e. BCBS, Aetna, Oxford, HIP and/or HCP. Obtains all Healthcare Partners referrals for existing Hauppauge patients providing all clinical documents as necessary. Advises staff of any insurance plan updates. Orders all specialty pharmacy drugs for Hauppauge patients, and maintains an accounting through the PODIS system. Covers for the surgical coordinator as needed (see separate job description) and any other support duties assigned by the office managers. Skills/qualifications: Knowledge of insurance company/managed care organization constraints related to the retinal practices office procedures, visits, testing and drug therapy. Computer, telephone and all business equipment skills needed. Good organizational skills and ability to handle multiple tasks. Ability to prioritize work related duties. Job Type: Full-time Salary: $20.00 - $24.00 per hour Benefits: 401(k) Dental insurance Health insurance Life insurance Paid time off Vision insurance Schedule: 8 hour shift Day shift Monday to Friday Ability to commute/relocate: Hauppauge, NY: Reliably commute or planning to relocate before starting work (Required) Experience: Insurance verification: 1 year (Preferred) Medical billing: 1 year (Preferred) Work Location: In person


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