Authorization & Billing Support Specialist, Senior

SUMMARY

Aid the Medical Coding Manager with coding unit operations. Provide administrative and clinical office support. Liaise between patients and physicians regarding insurance policies and procedures.

Job Responsibilities

• Validate patient insurance.
  • Appeal denials, write appeal letters, provide medical records.
  • Review Task Manager, respond to denials, correct open encounters.
  • Administer insurance websites, oversee passwords.
• Collect insurance referrals and prior authorization for testing and procedures.
  • Authorize and manage Neuro Psychiatric Testing.
  • Ensure approvals in EMR and CERNER systems.
  • Promote department goals by training team members on insurance policies.
• Stay current on guidelines set by insurance. Educate staff and providers on policies and procedures. Act as liaison and problem solver between physician and staff regarding coding and charge entry. Resolve coding issues based on industry best practices. Analyze, code, and abstract information for diagnosis and procedure codes. Resolve discrepancies. Document denial trends and provide in-services for continuous improvement. Inform staff and self-pays about UH financial aid and Medicaid applications. Ensure accurate documentation in EMR and scanned into CERNER. Provide data for CPMP Patient Accounts. Initiate Source Document to add new CPT Codes to Patient Keeper and Cerner. Identify and implement process improvements.
• Attend meetings and perform other duties as assigned.

Required Education & Qualifications

• Associate’s degree; 2 additional years of experience in healthcare environment.
• 3 years of full-time experience in healthcare environment.
• Knowledge of insurance verification/update, scheduling, assist with prior pre-authorization or obtaining referrals process.
• Strong organizational and communication skills (verbal and written).
• Excellent attention to detail.
• Exceptional telephone etiquette.
• Proficient in Microsoft Office.

Preferred Qualifications

• Bachelor’s Degree.
• EMR experience - Cerner/IDX.
• Experience with patient scheduling.

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to communicate with patients, staff and medical providers. The employee must be able to exchange accurate information in these situations. This position is largely sedentary and requires the employee to remain stationary for a majority of the day. Any additional physical demands will be outlined and provided by management.

Salary Range

$24.15 - $30.18 per hour. Individual compensation discussions begin during the hiring process and may occur during job review and promotional opportunities. Salaries vary depending on experience, education and current market for the position. Human Resources determines the external and internal equitable salary for each employee.

Benefits

Our compensation philosophy aims to provide marketable compensation programs and to compensate employees based on relevant experience and education. Benefits may vary based on employment status and location.

Pay & Schedule

Full-time, days/hours: Monday - Friday; 8:30 AM - 5:00 PM.

Qualifications

Equal Employment Opportunity (EEO) Statement: CPMP provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, sexual orientation, gender identity or expression, or any other legally protected status. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall and transfer, leaves of absence, compensation and training.