Insurance Coordinator

Responsibilities

• Research and verify financial coverage with third-party payers for planned services prior to patient's scheduled appointment.
• Complete authorization requirements for the patient's specific plan and communicate limitations or denials to patient/family.
• Refer cases to outpatient Care Managers or Social Workers when patients are unable to pay for services or services are not covered under a third-party payer.
• Document receipt and forward appropriate forms (such as a primary care physician referral or a signed agreement to self-pay) to Patient Financial Services.
• Document all financial clearance information in Information System.
• Cook up and authorize clinic referral processes, including expediting responses to referral inquiries, ensuring benefits are available, obtaining insurance authorizations, assessing clinical information of referrals, and gathering social and demographic information to support.
• Screen and respond to requests for general information regarding SRAlab lab services and programs.
• Identify and verify patient benefits and initiate the pre-certification process by accessing insurance company, Medicare, and/or Medicaid databases.
• Implement improvements to enhance efficiency and outcomes and to solve unique or complicated problems.
• Update demographic, insurance, funding, and medical information in SRAlab's Information System, as needed.
• Communicate information to the outpatient clinical team or SRAlab inpatient Care Managers as needed.
• Communicate all actual or potential denials to Financial Clearance Supervisor.

Qualifications

• Minimum educational requirement: High school degree or equivalent, Associate College degree preferred.
• Minimum of 2 years of experience normally acquired through prior insurance authorization or pre-certification experience.
• Knowledge of rehabilitation medicine preferred.
• Working knowledge of Windows operating environment and Microsoft Office software applications.
• Strong customer service and interpersonal skills necessary to interact with all levels of SRAlab personnel, physicians, insurance representatives, and other internal and external customers.
• Analytical skills necessary to ensure complete, accurate, and timely financial clearance is obtained for all outpatients receiving rehabilitation services at SRAlab.
• Proficiency in keyboarding skills.
• Application of a variety of a variety of moderately complex computer PC software.