September 6, 2024

Plessen Ophthalmology

St Thomas

Insurance Verification and Surgery Coordinator

POSITION SUMMARY
Performs insurance verification. Responsibilities include but not limited to heavy phone contact with managed care companies, communicate with insurance companys authorization department regarding any CPT code discrepancies (as assigned), and contact patient prior to appointment if there are any insurance/ authorization issues. Assists with surgery coordination.

ESSENTIAL FUNCTIONS include the following:
Accurately enter insurance information into computer system.
Responsible for pre-certification/ authorization and insurance verification for all patients.
Research, follow up and resolve open & pending authorizations in a timely manner
Calculate cash estimates for patients on upcoming visits/ procedures.
Contact patients regarding financial obligations.
Documents activity in the patient accounts.
Concisely, precisely and accurately document all information.
Maintain clear communication with patients as well as insurance companies.
Answer phone for incoming calls, make outgoing calls.
Maintain strict confidentiality of patient and center related business.
Obtain prior authorization for procedures.
Scanning medical documents into patient accounts
Assists with surgery scheduling when needed
Obtains signature from patient on Informed Consents and Post-Operative Release forms
Counsels patient on all outpatient surgical instructions
Prepares surgery chart for each doctor, including pre-certifying surgery; getting the post op report from the referring doctor; typing discharge letter and sending to referring doctors; getting instructions, calendar and eye drops together for patients post-surgery.
Perform other responsibilities as assigned to support the practice Mission, Vision and Values.
Completes all required compliance training.
KNOWLEDGE, SKILLS, & ABILITIES
Knowledge of CPT, ICD-9 and ICD-10 Codes.
Strong understanding of benefits investigating; deductibles, co-insurance, out of pocket expense & benefit exclusions.
Ability to effectively handle multiple responsibilities simultaneously in a deadline driven environment.
Excellent verbal, written communication and interpersonal skills.
Ability to work independently and as part of a team and take on new tasks.
Attention to detail.
Ability to exhibit a high level of confidentiality.
Basic knowledge of dental and vision insurance verification.
Ability to read, analyze, and interpret general health and social services guidelines, technical procedures or governmental regulations.
Ability to write reports, health correspondence and procedure manuals. Ability to effectively present information and respond to questions from groups or patients, center staff, and the general public.
Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent.
Able to provide excellent customer service..
Position requires accuracy, thoroughness, and an understanding of insurance, and medical billing procedures.
Work is fast paced and multi-tasked.
Requires ability to work as a team member.
Skill in operating computer, word processing software, fax machines and copier machines.
Must be able to communicate via the telephone
Must be able to view and type computer data

EDUCATION AND/OR EXPERIENCE
High school diploma or GED
Previous insurance verification experience is required.
Previous surgery scheduling experience is preferred
Intermediate experience with MS Word, MS Excel, MS Outlook.
Experience working with e Clinical Works is a plus!