Insurance Coordinator

Insurance Coordinator

Department: Medical Affairs

Employment Type: Full Time

Location: Remote, U.S.

Compensation: $50,000 - $55,000 / year

Description
The Insurance Coordinator will report to the Patient Access Supervisor and will be responsible for submitting and following up on all pre-authorization requests to payers, submitting and following up on appeals, and verifying patient insurance. The Insurance Coordinator will also assist with other duties as assigned by the Patient Access Supervisor.

Responsibilities
? Submit prior authorization (PA) requests and appeals to insurance payers, ensuring timely and accurate processing.
? Maintain responsibility for timely follow up on filed PA requests and appeals with insurance companies via telephone, writing, or the payer website to obtain decision letters regarding authorizations, denials.
? Review approval and denial letters to determine appropriate next step and strategies.
? Verify patient insurance coverage as needed to ensure proper processing and accurately determine patients? primary insurance.
? Communicate with patients to provide updates on insurance matters and gather necessary information as needed.
? Accurately calculate Out-of-Pocket cost for patients who have received authorization.
? Determine and obtain Single Case Agreement for patients who have received authorization and follow up with insurance company to obtain if necessary.
? Obtain HMO referrals from provider offices.
? Document all activities as needed in various reports, including prompt, accurate, and complete notes in CRM system.
? Manage a balanced caseload effectively to meet organizational goals.
? Collaborate regularly with cross-functional teams to ensure seamless communication and alignment.

Requirements
? 4+ years? experience within a medical office setting.
? Excellent customer service skills and phone manners.
? Experience in a high-volume environment.
? Strong written and verbal communication skills.
? Self-motivated with the ability to adapt to new situations, prioritize work and solve problems.
? High School Diploma or GED.
? Knowledge of various insurance plans and HIPAA.
? Basic comprehension of computer programs, including Microsoft Excel, Word, and PowerPoint.

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