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Title

Pre Certification and Insurance Specialist 

Category Patient Services  
Description

POSITION SUMMARY: The Pre-Certification and Insurance Specialist ensure that all patient insurance is verified as active, any pre-certifications and or referrals are obtained, and both office staff and patients are made aware of responsible balances due.

 
Position Requirements

ESSENTIAL RESPONSIBILITIES:

  • Develops effective relationships with insurance company representatives.
  • Utilize ICD-9 and CPT codes to ensure proper authorization for procedure and claims payment.
  • Responsible for explaining benefits, the billing process and financial responsibilities to patients.
  • Responsible for obtaining complete and accurate insurance information, benefit verification, accurately interpreting benefit plans and investigating pertinent details. Notifies supervisor of know or potential issues.
  • Responsible for obtaining and communication pre-authorization as needed per insurance company requirements.
  • Responsible for obtaining and communicating all Primary Care Physicians referrals as required per insurance.
  • Responsible for tracking, obtaining and extending authorizations from various carriers ina timely manner.
  • Record insurance information to maintain data through the Referral/Insurance Verification process and communicates insurance information to pertinent staff.
  • Independently works from the Eyecare database, Availity, CSnap and other electronic resources.
  • Track a significant amount of data and information, preparing and producing meaningful information.
  • Provides detailed, accurate and current clinical information to insurance representatives.
  • Follow up on requests for authorization for service on unpaid claims as requested by Central Billing.
  • Maintain a strong working knowledge of precertification and referral requirements by insurance carrier.
  • Perform any other related duties as directed by the immediate supervisor

EDUCATION AND/OR EXPERIENCE:

  • High School diploma or equivalent
  • Minimum of one (1) year experience in the role of Pre-Certification and Insurance Specialist, Intake Representative, Insurance Representative, or Prior Authorization Representative or related field in a healthcare setting.
 
Full-Time/Part-Time Full-Time  
Shift Days  
Pay Rate $13.38/hour  
Position Status Full Time  
Manages Others No  
Travel Required No  
Position Pre Certification and Insurance Specialist  
Exempt/Non-Exempt Non-Exempt  
Location Cataract and Laser Institute-Indianapolis  
About the Organization The vision of the doctors and staff of Midwest Eye Consultants is to provide our patients with excellence in eye health care. In order to fulfill this vision, the doctors of Optometry and Ophthalmology, along with our technicians, opticians and patient services staff, embrace the ongoing evolution in eye care through expanded technology and knowledge. In addition, our doctors of optometry work hand in hand with doctors of ophthalmology, enabling us to provide both primary and secondary care.  
EOE Statement We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status or any other characteristic protected by law.  
supervisorUID None Specified 


This position is currently not accepting applications.

To search for an open position, please go to http://MidwestEyeConsultants.appone.com



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