Insurance Verification and Prior Authorization Specialist at USA Vein Clinics

USA Clinics Group is a healthcare organization that values organization, motivation, and excellent customer service. They offer a range of benefits including medical, dental, and vision insurance, as well as a 401K match. The Insurance Verification/ Prior Authorization Specialist is responsible for obtaining referrals and authorizations prior to service dates for tests, procedures, and admissions into the clinics. The role involves active communication with staff, scheduling patients, interacting with various stakeholders, and respecting patient confidentiality. The candidate must have strong computer, typing, data entry, and organizational skills. Prior experience in a healthcare setting and knowledge of billing and coding is preferred. Responsibilities: - Review referring physician and patient documentation for Medical Necessity against insurance protocol requirements for pre-certification purposes - Communicate actively with staff regarding status of authorization - Communicate the need for reschedule and/or cancellation if authorization not in-hand - Direct liaison to offices and patients regarding new, changed, or pending insurance authorizations - Responsible for scheduling STAT, emergent patients for outpatient diagnostic exams - Interact with patients, their representatives, physicians, physician office staff, and others to gather and ensure accuracy of demographic, billing and clinical information - Produce and distribute required forms with accurate patient information - Respect and protect the patient’s rights to confidentiality and privacy - Display a positive attitude when interacting with provider’s office staff, providers and fellow employees - Perform additional duties as assigned

Insurance Verification and Prior Authorization Specialist

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