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Insurance and Referral Authorization Specialist

Company: Frederick Health
Location: Frederick
Posted on: June 6, 2021

Job Description:

This Insurance and Referral Authorization Specialist is responsible for providing administrative support to patients and medical professionals within and outside of Frederick Health Medical Group. The position completes all patient insurance carrier referrals, insurance authorizations for in-house procedures/services, insurance eligibility, benefits, pre-determinations and price estimations. These responsibilities and requirements must be met prior to the delivery of outpatient ambulatory services. Responsible for verifying patient demographic and financial information for all insurances and self-pay accounts.The Insurance and Referral Authorization Specialist is responsible for accurately and professionally answering a multi-line telephone system and addressing patients' requests/concerns. This position assists with care coordination central to the objectives of Patient Centered Medical Home and is focused on utilizing a team based approach to improve outcomes for all patients. Provide premier customer service to all referring physicians and their office staff by obtaining necessary insurance requirements to help provide exceptional care to the patient and improve cash flow. Performs other related departmental duties which may not be listed in the position description.Required:High school diploma or GED required. Some college coursework preferred related to Business/Health SciencesThree to four years of prior experience in a healthcare office setting, clinical/vocational training and/or a Certified Medical Assistant is required; Additional education/experience may be substituted for clinical experiencePossess intermediate proficiency and accuracy in the use of software programs such as Microsoft Word, Microsoft Outlook, Excel, Meditech 6.1, Meditech Expanse and NextGen (EHR based system)Possess familiarity with medical terminology, medications, medical procedures, advanced hi-tech radiology and surgical procedures for all specialty services.Understand and be familiar with State of Maryland medical insurance carriers, both commercial and state governed, and possess an understanding of medical insurance policies and procedural/clinical based guidelines. Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)

Keywords: Frederick Health, Frederick , Insurance and Referral Authorization Specialist, Other , Frederick, Maryland

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