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Insurance Authorization Representative

2 months ago

Ashland, Pennsylvania, United States Mid-State Health Center Full time
Job Overview

Position Summary

The mission of Mid-State Health Center is to deliver quality primary care to the community, ensuring accessibility for all individuals, regardless of their financial situation.


KEY RESPONSIBILITIES:

As a Referral Representative, you will support the Referral Coordinator in managing insurance authorizations for referrals and medical orders. Your role will encompass various tasks within the patient services department, including:

  • Assisting in the completion of pre-certifications for radiology and behavioral health appointments.
  • Initiating appeals and managing insurance referrals.
  • Coordinating and scheduling patient appointments, including referrals as necessary.
  • Documenting and tracking all referral activities accurately.
  • Facilitating Veteran's Affairs authorizations and cross-border referrals.
  • Providing exceptional customer service and maintaining attention to detail in all tasks.
  • Traveling between office locations as required.
  • Communicating effectively with team members and patients.
  • Verifying and maintaining accurate patient records.
  • Addressing patient inquiries regarding appointments and follow-up care.
  • Ensuring proper scheduling and confirmation of patient appointments.

ADDITIONAL DUTIES:

  • Complying with HIPAA regulations to protect patient privacy.
  • Greeting and registering patients in a friendly and efficient manner.
  • Managing incoming calls and providing necessary information.
  • Completing essential paperwork, including medical releases and HIPAA forms.
  • Overseeing the waiting area and coordinating patient flow.
  • Assisting with clerical tasks as needed.
  • Balancing collected payments and ensuring secure handling.
  • Maintaining a clean and organized waiting area.
  • Participating in required meetings and training sessions.
  • Performing other assigned duties as necessary.

QUALIFICATIONS:

  • High school diploma or GED is required.
  • At least one year of experience in a customer service role, with six months in a healthcare setting preferred.
  • Familiarity with medical terminology and office equipment.
  • Proficiency in word processing and computer applications.

SKILLS AND ABILITIES:

  • Strong organizational and supervisory skills.
  • Ability to evaluate and improve existing processes.
  • Proficient in operating various office equipment and software.
  • Effective communication skills, both verbal and written.
  • Ability to prioritize tasks and manage multiple requests.
  • Experience in interacting with diverse populations.
  • Basic financial and analytical skills are desirable.

WORK ENVIRONMENT:
Work is conducted in an office setting with frequent patient interaction. The role may involve stressful situations and requires adaptability to interruptions.

BENEFITS:
Mid-State Health Center offers a comprehensive benefits package, including health, dental, and vision insurance, tuition reimbursement, life insurance, retirement plans, and paid time off.