Insurance Eligibility & Authorization Specialist

Texas Retina Associates; Plano (TX); On-site; USD 40,000 - 60,000; Full time

Job summary

Texas Retina Associates, the DFW area's leading retina specialty practice, seeks an Eligibility Specialist in our Plano office to support payer and patient account authorizations, verifications and predeterminations across 15 locations. You will work with Revenue Cycle Director and insurance providers to ensure timely processing and accurate demographic data.

Responsibilities include coordinating benefits, resolving insurance issues, and answering routine inquiries while following procedures and

Qualifications

• High School diploma or equivalent required.
• Minimum two (2) years combined medical insurance authorization and verification experience required.
• Demonstrate knowledge of state, federal, and third-party claims processing required.
• Demonstrate knowledge of state & federal collections guidelines.
• Experience with NextGen preferred.
• Must successfully complete required training within 90 days of occupying position.

Responsibilities

• Verify insurance, coordination of benefits and prior authorization as needed.
• Work with insurance representatives to confirm all claims and submit to ensure timely payments.
• Collaborate with co-workers to resolve insurance errors.
• Contact patients to verify demographics and insurance details; update systems and document conversations.
• Answer patient insurance questions and resolve complaints.
• Assist in implementing procedures to improve processing quality.

Skills

Communication skills

English proficiency

Attention to detail

Independent judgment

Problem solving

Microsoft Office

Education

High School diploma or equivalent

Job description

Texas Retina Associates, the DFW area's leading retina specialty practice, seeks an Eligibility Specialist in our Plano office to support payer and patient account authorizations, verifications and predeterminations across 15 locations. You will work with Revenue Cycle Director and insurance providers to ensure timely processing and accurate demographic data.

Responsibilities include coordinating benefits, resolving insurance issues, and answering routine inquiries while following procedures and