Under the direction of the Financial Coordinator Supervisor, ensures that all information necessary for proper financial reimbursement for high dollar patient care is analyzed and submitted to insurance companies for approval prior to the patient's date of service. Collaborates with insurance companies and physician offices when necessary to verify eligibility and authorization requirements to ensure financial reimbursement for services.
Perform all insurance verification for eligibility, coverage, and authorization requirements via Web or phone with third party payers.
Contacts providers and insurance companies to validate data, collect missing information and resolve information discrepancies, -Understands clinical guidelines for payors requiring authorization to better build cases for authorization requests and provide feedback to clinical departments on required notes.
Work closely with physician offices obtaining authorization for inpatient and outpatient services
Qualifications:
High school graduate or equivalent; some college preferred
1-2 years of insurance, third party payor or secretarial experience in a health care setting required
Knowledge and Skills
Medical Terminology required
Analytical ability to gather and interpret data and communicate desired outcomes orally and in writing in a professional manner
Strong communication and interpersonal skills
Ability to handle multiple duties
Newton-Wellesley Hospital will provide equal employment opportunities to all applicants and employees without regard to race, color, religion, gender age, national origin, disability, marital status, genetic information, veteran or active military status, gender identity or expression, or sexual orientation.