Insurance Authorization Specialist

Company: Caritas Holy Family Hospital and Medical Center
Facility: Holy Family Hospital & Medical Center at Methuen
Department:


Verifies insurance eligibility, benefits, and preauthorization / referral / billing requirements Responsible for consistent and accurate use and execution of supporting departmental SOP s (operating procedures / processes) and supporting tools, software, websites Identifies patient preauthorization / referral requirements and ensures they are met / in place in timely fashion to facilitate efficient billing and payment for elective, emergent and urgent admissions as well as elective and add-on procedures Reviews and resolve preauth / referral issues identified via exception reports / reporting Contacts insurance companies to verify / validate requirements to ensure accuracy in the preauth / referral process Contacts and educates patients and physicians / physician office staff to ensure compliance with identified payor requirements Identifies current and prior patient responsible balances, educates patients on their financial responsibilities, and collects same Identifies self pay patients, identifies potential solution(s), and facilitates solution application process (manual and/or electronic) or patient payment as appropriate Serve as subject matter expert for assigned payor(s) as directed by patient access leadership while demonstrating broad knowledge of all payors in hospital s portfolio Meets performance standards established by Patient Access leadership, including but not limited to: quality, collections, customer service, screening/solution rates, productivity) Works effectively with patient access peers and other hospital departments Delivers exemplary customer service for patients in accordance with hospital expectations / guidelines Performs other duties as required. Excellent customer service/communication skills required. Ability to work with a high degree of confidentiality. Aptitude / familiarity with patient access tools, systems, and technologies Comfortable with securing solutions for uninsured patients Medical Terminology and working knowledge of Coding knowledge required. Knowledge of health insurance and reimbursement/billing required * Ability to Multi task 2-3 years in a similar environment Part-time Day & Evening