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Health Insurance and Authorization Specialist II
1 day ago
Job Description
he Health Insurance and Authorization Specialist is responsible to assess and perform quality control function for all preadmission visits on surgical inpatient, short stay 23 (SS23), Endo and ambulatory procedures ensuring all pertinent information is on file and accurately documented. These activities include review diagnosis and history for correct insurance coverage, insurance eligibility and coverage verification using the three patient identifiers, confirming prior authorization is on file for correct level of care, inquires on prior auth denials and works with the Provider's office to resolve, requests estimated cost and collects deposits for non-covered services, ensures appropriate medical justification is documented for out-of-network payers, refers our self-pay patients to Financial Case Management (FCM) for Medicaid assessment or Financial Assistance, reviews and validates MSP questions, monitors Medicare days for exhausted benefits, identifies and resolves coordination of benefits discrepancies, and notifies Utilization Management of additional clinical requests
Salary Range:
$ $26.49 an hour
The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job's compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations.
Auto req ID
17818BR
City
Rochester
Area of Interest
Clerical
Employment Status
Full-Time
Hours/Week
40hrs
Job Requirements
- Education: High school Diploma or equivalent required. Associate degree preferred in related discipline (admitting/registration/patient billing/insurance); or equivalent experience
- Experience: Minimum of 3 years of related experience preferably in a hospital setting, medical office billing and or knowledge of third-party insurance regulations.
- Skills: Require high degree of professionalism and motivation with excellent communication and customer service skills, and medical terminology. Good interpersonal and telephone skills. Detail oriented. Computer, copier and FAX skills.
