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Pre Authorization Clerk - Full Time; Rehab Department

Company

C. F. Knight, Inc.
Address Bonners Ferry, ID, United States
Employment type FULL_TIME
Salary
Category Construction
Expires 2023-09-04
Posted at 9 months ago
Job Description
POSITION QUALIFICATIONS:
  • Medical Insurance authorization experience preferred
  • Must be proficient in using telephone, scanner, copier, and other office equipment.
  • Minimum two (2) years clerical office experience. Preferably in medical office environment.
  • High school diploma required
  • Keyboard at 45 wpm accurately required
  • Proficient in Microsoft office products required, prefer Electronic Medical records experience Meditech and WellSky.
  • Must have proven excellent interpersonal skills and customer service skills in person and over the phone
  • Medical terminology required
  • Detail oriented with effective time management skills
  • Basic Live Support BLS required within 60 days
ESSENTIAL JOB DUTIES/REQUIREMENTS:
General
  • Assists patients in understanding insurance benefits and refers uninsured patients to Patient Financial Services staff for further explanation of hospital policies regarding up-front or Point of Service collection of Co-insurance, Deductibles and/or other billing information.
  • Obtains diagnosis code(s) from provider ordering service
  • Scans documents into EHR to document pre-authorization, insurance documents, etc.
  • Accurately completes pre-authorization forms as needed to ensure timely submission to Insurers; maintains detailed notes/audit trail on all communication/contact with Insurers until pre-authorization is obtained or otherwise documented as “not required.”
  • Performs pre-authorizations and Re-authorizations for hospital outpatient, and clinic services that require pre-authorization.
  • Follows established pre-authorization policies and procedures.
  • Pre-registers Rehab patients in the hospital EHR system (currently Meditech) in order to document in Meditech as well as the rehab specific software WellSky. Assists with pre-registration of Hospital Outpatients when needed which may include verification and documentation of patient’s Insurance eligibility/benefits.
  • Responsible for obtaining all patient demographics/insurance information needed for subsequent submission of claims for authorized billed services, (e.g., patient name, date of birth, mailing address, insurance information, workers compensation claim number, date of injury and claim handler, etc.).
Rehabilitation Department Specific Duties include:
  • Processes billing charges for the department.
  • Maintains positive and effective working relationship with other departments, medical staff, community agencies and other health care agencies.
  • Receives incoming telephone calls for the department, obtains caller’s name, and forwards call to appropriate person or takes a message.
  • Schedules appointments, coordinates patient referrals.
  • Greets clients and visitors and directs to appropriate treatment area.
  • Demonstrates excellent customer service skills when conversing with associates, patients, insurance representatives, and clinical staff over the phone and via fax or email.
  • Communicates with clinicians/therapists about upcoming re-authorizations and ensures that insurance requests match the clinician’s plan of care.
  • Maintaining regular attendance and punctuality is a required essential function of this position.
  • Is the back up for the Administrative Assistance III (Rehab front desk position)
  • Provides information and assistance to clients and customers.
  • Excellent problem solving and critical thinking skills
  • Reviews appointment schedule and patient charts to ensure ongoing eligibility, compliance with authorization and certification dates, numbers of visits, and other service limitations or caps.
  • Provides clerical support for the clinicians/therapists including preparing charts, gathering patient health history, administering FOTO, printing or collecting relevant reports.
  • Must demonstrate ability to tactfully handle difficult situations with patients, families and physicians.