Overview
Job Summary
Verifies insurance payors and submits authorizations for all Atrium Health at Home patients and referrals.
Essential Functions
Complete insurance verifications on various payors for patients.
- Utilize various payor websites for insurance verifications and authorization submissions.
- Identify trends in authorization submission amongst various payors.
- Contact payors and 3rd party vendors directly when escalation of verification of benefits or authorization issues arise.
- Research patient accounts to assist with claim rejections and denials.
- Process new/updated payor changes, as needed.
- Properly document accounts clearly in appropriate areas of patient records discussing insurance verification and/or authorization needs.
- Receive, review, and take action for all communications (emails, phone calls, etc) with the department relating to insurance.
- Monitor multiple referral portals and payor softwares for communication
- Work under specific turnaround times on specific workflows to meet department and/or patient goals.
- Ensure all work is compliant with Privacy, HIPAA, and regulatory requirements.
- Adhere to policies and procedures as required by department and payor guidance.
- Attend regular meetings/trainings as set forth by leadership.
- Participate in assignments set forth by leadership.
- Report any compliance concerns to department leaders.
Physical Requirements
Work requires long periods of sitting and manual dexterity. Much multitasking between email, faxes, and multiple software systems in a fast-paced environment. The ability to focus and pay attention to details is necessary. +Health insurance verification and authorization experience necessary+
Education, Experience and Certifications
High School Diploma or GED required. 2 years' experience in a medical retail, medical office setting or equivalent combination of training, education, and experience.