Vitreoretinal Consultants of NY is the premier retinal care destination for patients across Long Island, Queens, NYC, and beyond. Founded in 1981, our team of nationally-recognized retina specialists and surgeons have established themselves as distinguished physicians, compassionate providers, and key thought leaders in the retina care community. We are committed to providing a compassionate and ethical environment that focuses on patient-centered care. From diagnostics to clinical trials, we bring clarity, transparency, and humanity to all aspects of what we do. We have a very high level of patient satisfaction and are proud of our reputation, online and in the medical community. https://www.vrcny.com/why-vrc
Job Purpose:
To verify eligibility of insurance, to confirm plan coverage for various office visits, medical procedures and treatments of patients to ensure timely payment of such visits. Advises physicians of any insurance/managed care constraints. Assists patients in obtaining funding through Chronic Disease Fund or Genentech Access to Care Foundation. Obtains or advises patients the need for proper referrals.
Duties:
- Verifies insurance/managed care plans for eligibility for all of the insurance plans listed in the patient account.
- Uses Athena to confirm eligibility and/or contacts the payer directly and documents the outcome in the patient account.
- Contacts patients directly when insurance has terminated or shows ineligible in attempts to obtain new information prior to office visits.
- Will pre-certify all patient testing, procedures and injections by confirming their insurance/managed care plan eligibility in addition to confirming whether prior authorization for visits and treatments are necessary.
- Advises both physician and patient of insurance findings and benefit investigations, discusses the possibility of supplemental funding through Chronic Disease Fund and Access to Care Foundation
- Will assist patients with the proper forms necessary for CDF and GATCF and confirm when funding is in place. Provides the proper clinical documentation to the foundations as needed.
- Obtains and/or advises patients of the need for referrals as indicated on their insurance plan, i.e. BCBS, Aetna, Oxford, HIP and/or HCP. Obtains all Healthcare Partners referrals for existing Hauppauge patients providing all clinical documents as necessary.
- Advises staff of any insurance plan updates.
- Orders all specialty pharmacy drugs for Hauppauge patients, and maintains an accounting through the PODIS system.
Skills/qualifications:
- Knowledge of insurance company/managed care organization constraints related to the retinal practice’s office procedures, visits, testing and drug therapy.
- Computer, telephone and all business equipment skills needed.
- Good organizational skills and ability to handle multiple tasks.
- Ability to prioritize work related duties.
Job Type: Full-time
Pay: $20.00 - $24.00 per hour
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Weekly day range:
Ability to commute/relocate:
- Hauppauge, NY: Reliably commute or planning to relocate before starting work (Required)
Experience:
- Insurance verification: 1 year (Preferred)
- Medical billing: 1 year (Preferred)
Work Location: In person