What are the responsibilities and job description for the INSURANCE AUTHORIZATION SPECIALIST - FT position at ONECORE HEALTH?
Overall Responsibility:
Responsible for ensuring all patient insurance eligibility benefits/authorizations are verified prior to patient admission. Responsible for providing accurate and complete data input for precertification requests.
Key tasks and responsibilities (essential functions):
- Contacts primary insurance to verify coverage, acquire authorization numbers and prepare patient cost estimate. The verification and estimating process will be completed within 48 hours of scheduling and in all instances prior to surgery. Must have thorough understanding of managed care concepts including HMO, PPO and POS.
- Meets with patients pre-operatively so they understand the billing process and their financial expectations, informing patient of deductibles and co-pays and providing payments arrangements for past due balances.
- Processes all benefit information and verifies all patient insurance data is valid for further collections, noting in and out of network benefits.
- Obtains facility authorizations for OneCore Health.
- Maintains confidentiality of all agency and patient related information. Protects patient rights as defined in the Patient Bill of Rights.
- Collects pre-payment from the patient when necessary. Records and processes payments according to departmental guidelines.
- Attends and participates in staff meetings, required in-services and other meetings as requested.
- Performs other duties or functions as assigned by Manager.
Licensure and Certification: None required.
Experience/Education: Must have a minimum of 3 years of experience in verifying insurance eligibility and acquiring authorizations from insurance providers, medical experience preferred. High school graduate or GED required.