Under the direction of the Scheduling Supervisor, responsible for insurance verification of in-patient, outpatient, and per-op encounters at time of registration. Performs electronic verification using integrated systems, and accesses web portals to submit electronic authorization requests. Utilizes fax back system for non electronic payers. Contacts third party payers and documents co-payments, co-insurance, deductible amounts and primary care physician information. Initiates pre-authorization and secures admission notification for all payers. Coordinates clinical documentation, orders, CPT codes, ICD9 codes with community and referring physicians. Submits all required authorization forms to payers in timely manner to prevent rejections and denials.

Required Skills

1. Ability to effectively and tactfully deal with employees, patients, visitors and the general public.
2. Basic computer literacy and keyboarding skills required.
3. Effective written and verbal communication skills required.
4. Analytical and problem-solving skills required.
5. Knowledge of commercial and managed care payers and terminology.
6. Bilingual English/Spanish preferred.

Required Experience

WORK EXPERIENCE:

One year health care admitting or scheduling experience or one year work experience in a related healthcare, business or finance position.

Healthcare or financial background preferred.

EDUCATION AND TRAINING:

High school diploma or equivalent. Some college hours preferred. Training or educational background with medical terminology and familiarity with ICD9 coding preferred.

1. Ability to effectively and tactfully deal with employees, patients, visitors and the general public.
2. Basic computer literacy and keyboarding skills required.
3. Effective written and verbal communication skills required.
4. Analytical and problem-solving skills required.
5. Knowledge of commercial and managed care payers and terminology.
6. Bilingual English/Spanish preferred.