Responsible for obtaining prior authorization from insurance payor for durable medical equipment.
Review and obtain necessary compliant documents, medical records and prescriptions in order to submit prior authorization.
Review & work pending task daily for authorizations &/or appeals
Contact patients to coordinate any necessary doctor’s appointments needed in order to submit authorization
Notify RT/Sales management teams regarding non-compliance and authorization deadlines that are not met
Establishes and maintains effective communication and good working relationship with co-workers for the patient’s benefit.
Performs other clerical tasks as needed, such as answering phones, faxing, and emailing. Completes other duties, as assigned
Communicates appropriately and clearly to Manager/Supervisor, and other superiors. Reports all concerns or issues directly to Collections Manager and Supervisor
Qualifications:
Requirements:
Learns and maintains knowledge of current patient database and billing system
Ability to submit and understand authorization requirements
General knowledge of government, regulatory billing and compliance regulations/policies for Medicare & Medicaid
Medical Terminology background
Enough knowledge of policies and procedures to accurately answer questions from internal and external customers.
Utilizes initiative; maintains set level of productivity goals with ability to consistently and accurately
Experience:
DME experience preferred
Worked a minimum of 1 year of insurance verification and authorization
Two years’ experience in insurance office, doctor's office, or three years’ general office experience.
Skills:
Superior organizational skill.
Attention to detail and accuracy.
Ability to work as part of a health care team.
Effectively communicate with physicians, patients, insurers, colleagues and staff
Proficient in Microsoft Office, including Outlook, Word, and Excel
