With customer service orientation, verifies patient’s insurance benefits and eligibility, obtains required authorization and coordinates services as ordered by the medical provider.

Required Skills

Customer Services:

• Provides exceptional customer service.
• Answering and referring inquiries within scope of business services.
• Telephone: Answers telephone, processes call, and document appropriately. Returns all messages in a timely manner.
• Maintains communication between medical providers, administrative staff, and/or patient/families.

Care Coordination:

• Assigns CPT and HCPCS codes based on provider order.

• Collect all required medical data and insurance information necessary to obtain necessary precertification.

• Verify insurance eligibility and benefits via phone and / or internet access. If authorization is required, submit all required information and documentation necessary.

• For services performed by JSMG providers, financial information to include deductibles, coinsurance and fees will be obtained from payer and communicated to patient / patient representative prior to service rendered.

• Schedule and confirm patient diagnostic appointments, surgeries, or consultations and communicate all information to the patient / patient representative.

• Ensure all needed medical and insurance information is transmitted to the facility or provider where the services are to be performed.

• Maintain adequate knowledge regarding coding and payer requirements.

• Scans and uploads patient clinical documents into medical chart.

Environmental Services:

• Contributes to the overall cleanliness and appearance of personal work space and department.

• Monitors supply levels and requests when needed.

• Maintains all equipment. Evaluates all equipment for damage or maintenance needs and reports when needed.

Required Experience

Minimum Education: High School diploma or G.E.D equivalent

Work Experience: One year or more experience in a medical setting.

Required License/ Certification/Registration: None

Skills:

• Excellent communication
• Ability to work tactfully and effectively with patients, family members, other employees and physicians.
• Knowledge of anatomy, physiology and medical terminology.
• Working knowledge of medical billing and managed care
• Familiarity of different insurance types.
• Word Processing / Computer
• Multi-tasking
• Time Management
• Organization
• Attention to Detail
• Professionalism / Positive Attitude
• Quality Focus
• Adaptability

Customer Services:

• Provides exceptional customer service.
• Answering and referring inquiries within scope of business services.
• Telephone: Answers telephone, processes call, and document appropriately. Returns all messages in a timely manner.
• Maintains communication between medical providers, administrative staff, and/or patient/families.

Care Coordination:

• Assigns CPT and HCPCS codes based on provider order.

• Collect all required medical data and insurance information necessary to obtain necessary precertification.

• Verify insurance eligibility and benefits via phone and / or internet access. If authorization is required, submit all required information and documentation necessary.

• For services performed by JSMG providers, financial information to include deductibles, coinsurance and fees will be obtained from payer and communicated to patient / patient representative prior to service rendered.

• Schedule and confirm patient diagnostic appointments, surgeries, or consultations and communicate all information to the patient / patient representative.

• Ensure all needed medical and insurance information is transmitted to the facility or provider where the services are to be performed.

• Maintain adequate knowledge regarding coding and payer requirements.

• Scans and uploads patient clinical documents into medical chart.

Environmental Services:

• Contributes to the overall cleanliness and appearance of personal work space and department.

• Monitors supply levels and requests when needed.

• Maintains all equipment. Evaluates all equipment for damage or maintenance needs and reports when needed.