Patient Benefits Coordinator

2 weeks ago

Wausau, Wisconsin, United States GastroIntestinal Associates, SC Full time
Job Summary

GastroIntestinal Associates, SC seeks a skilled Patient Benefits Specialist to obtain pre-authorizations/pre-certifications for upcoming procedures and coordinate referrals to outside facilities or providers.


Key Responsibilities
  • Obtain pre-authorizations/pre-certifications for upcoming procedures, radiology or diagnostic testing, laboratory or other special testing.
  • Work with reception and clinical staff to coordinate referrals to outside facilities or providers.
  • Verify Medicare, Medicaid and health insurance eligibility prior to upcoming services and procedures.
  • Contact patients prior to appointment or procedure to discuss insurance coverage and benefits and patient financial responsibility.
  • Inform Patient Account Representatives of new or different insurance plans for patients, in case claims need to be resubmitted to the correct payer.
  • Manage appointment frequency, insurance coverage and benefits for patients on infusion therapy.
  • Maintain up-to-date knowledge of clinical guidelines, precertification requirements, and medical policies for services and procedures.
  • Act as administrator for the insurance websites and obtain and maintain logon access to all payers' websites.

Requirements
  • Education: High school diploma or equivalent required.
  • Licensure/Certification: Advanced training/certification in medical billing, coding, and/or insurance preferred.
  • Experience: Minimum of one-year experience in a medical billing role is required, or equivalent education.

Competencies
  • Knowledge: Working knowledge of medical and insurance terminology, CPT, HCPCS, and ICD-10 coding.
  • Skills: Interpersonal, communication, and listening skills necessary to deal effectively and courteously with patients and all staff members.
  • Abilities: Ability to maintain strict confidentiality of fiscal and health information, work in a fast-paced environment, and prepare and gather information accurately and efficiently.
Job Posted by GastroIntestinal Associates, SC

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