Insurance Verification Specialist

Job Title: Insurance Authorization Specialist

SUMMARY

Our growing eye care organization has an immediate need for an Insurance Authorization Specialist who will handle all aspects of insurance authorizations for optical services and procedures.

ESSENTIAL DUTIES AND RESPONSIBILITIES

• File requests for prior authorization for all insurances that require based upon plan or insurance contract
• Request, obtain, and document all prior authorizations (or denials of same) appropriately and in a timely manner
• Obtain information about patient insurance coverage, benefits and eligibility
• Maintain and update internal listing of insurance carriers that require authorization
• Run system-generated reports to verify procedures by insurances requiring authorization are being captured
• Assist collection team with obtaining retro authorizations
• Coordinate with Call Center and Optical Offices on prior authorization and patient billing activity
• Maintain the strictest confidentiality in accordance with HIPAA regulations and clinic requirements

QUALIFICATIONS

• Comprehensive understanding of insurance verification, contract benefits and medical terminology
• Ability to enter data into various electronic systems while maintaining the integrity and accuracy of the data
• Professional and calming tone of voice free of use of inappropriate grammar
• Attentive listening skills
• Ability to function effectively under stress of conflicting demands on time and attention, while successfully meeting deadlines
• Ability to clearly articulate a response using appropriate voice modulation
• Strong Verbal and Written skills
• Ability to maintain control of a call de-escalating issues and instilling confidence that a resolution will be found
• Ability to perform essential job function with high degree of independence, flexibility, and creative problem-solving techniques
• Excellent organization, time management, and prioritization skills

EDUCATION AND/OR EXPERIENCE

• High school diploma or equivalent required

• 2+ years' experience medical authorizations

LICENSES AND CREDENTIALS

• Minimum Required: None

SYSTEMS AND TECHNOLOGY

• Proficient in Microsoft Excel, Word, PowerPoint, Outlook

Physical Requirements:

• While performing the duties of this job, the employee is regularly required to talk and listen. The employee is occasionally required to stoop, kneel, crouch or crawl. The employee must frequently lift and/or move up to 10 pounds.

• Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.

If you need assistance with this application, please contact (636) 227-2600

EyeCare Partners is an equal opportunity/affirmative action employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status. Please do not contact the office directly - only resumes submitted through this website will be considered.

NOTE: Job descriptions are intended to be accurate reflections of those principal job elements essential for making fair pay decisions about jobs. Nothing in this job description restricts management right to assign or reassign duties and responsibilities to this job at any time.