Prior Authorization Rep

Job TitleQualificationsEducationHigh school diploma or equivalentAssociate degree preferredExperience/SkillsHas one year patient access, medical billing, or prior authorization experiencePossesses medical terminology and CPT/HCPCS/ICD-10 coding knowledgeDemonstrates proficiency in Meditech and MS ExcelProfessionally collaborates with staff at various levels throughout the organization, including, but not limited to: Physician Practices, HIM, Information Systems, Patient Financial Services and Clinical DirectorsWorks efficiently with minimal supervisionRemains flexible to accommodate staffing shortages in the Patient Access departmentRequired Licenses/CertificationsN/AWorking ConditionsWorks in a well-ventilated, well-lit general office environmentWorks well under pressure with attention to time constraintsRoutine ResponsibilitiesBehavioral ExpectationsConsistently complies with established Behavioral ExpectationsEssential DutiesCalls patient prior to service to verify demographics and insurance, and notifies of copay amount that is expected at time of serviceVerifies insurance eligibility and benefits directly with payer or on payer Website prior to scheduled appointmentPre-registers patient in Meditech and ensures billing information matches in Athena for clinical staffPrints face sheet and labelsDocuments when unable to reach patient prior to visit so that department secretary can verify demographic information at time of serviceIndicates copay amount due on the face sheet sent over to officeEducates insured patient on their insurance benefits payment obligations and installment requirements prior to servicesDocuments all information obtained during pre-registration activitiesIdentifies uninsured, underinsured and low-income patientsRefers uninsured, underinsured, and low-income patients to Financial Counselors for financial assistance options and other arrangements prior to patient visitCollaborates with Patient Account Reps and Front Desk staff before patient is seen to prevent avoidable write-offsFull time/Day shift 80 hours/Biweekly