Prior Authorization/Insurance Specialist

Talley Eye Institute; Evansville (IN); On-site; USD 42,000 - 54,000; Full time

Benefits offered by this job

Health insurance

Paid time off

Parental leave

401(k)

401(k) matching

Dental insurance

Vision

Health Clinic

Vacation

PTO - Day 1 of Employment

Paid Holidays

Family friendly atmosphere

Aflac

Job summary

Talley Eye Institute in Evansville, IN is seeking an Insurance Specialist to manage injection authorizations, verify benefits, and explain patient out-of-pocket costs within the Billing Department.

You will collaborate with retina technicians and physicians, enroll patients in assistance programs, and help prevent billing errors by improving processes and coordinating with front-office staff. Strong communication and organizational skills are essential to handle multiple tasks and work as a team.

Qualifications

• Excellent communication skills, written and oral.
• Strong organization skills with attention to detail.
• Excellent follow-up skills.
• Management of multiple tasks simultaneously.
• Ability to work as a team player.

Responsibilities

• Injection authorizations: determine medications allowed, obtain prior authorizations if needed, heavy phone contact with patients and providers.
• Patient assistance programs: enroll patients in payment assistance programs and ensure correct billing.
• Additional duties: improve processes to reduce errors, assist front office, help patients with balances.

Education

High school diploma or equivalent

Two years minimum experience in medical office

Job description

Benefits:

• Health insurance
• Paid time off
• Parental leave
• 401(k)
• 401(k) matching
• Dental insurance

POSITION: Insurance Specialist

DEPARTMENT: Billing

REPORTS TO: Billing Manager

Job Summary: This individual is responsible for injection authorization, checking insurance benefits, and out of pocket expenses.

Education and Experience:

• 1. High school diploma or equivalent.
• 2. Two years minimum experience in medical office, insurance experience preferred.

Essential Skills and Abilities:

• 1. Excellent communication skills, written and oral.
• 2. Strong organization skills with attention to detail.
• 3. Excellent follow-up skills.
• 4. Management of multiple tasks simultaneously.
• 5. Ability to work as a team player.

RESPONSIBILITIES:

• 1. Injection authorizations:
  • a. Works with retina technicians and physicians on determining which medications the patient can have vs. which ones will require a sample or prior authorization.
  • b. Performs a thorough benefits investigation on patients when injections are recommended for treatment.
  • c. If needed, obtain prior authorizations for injections by contacting third party payors via fax or other TEI approved methods.
  • d. Heavy phone contact communication.
• 2. Patient assistance programs:
  • a. Work directly with patients and staff to get patients signed up for payment assistance programs, including Good Days, CDF, etc.
  • b. Enroll patients in assistance programs as needed.
  • c. Work with other individuals in RCM department to ensure that patients are not erroneously billed for out-of-pocket expense.
• 3. Additional Duties:
  • a. Work with administration and supervisor to look for ways to make processes work more smoothly and reduce the opportunity for errors in the benefits process.
  • b. Assist front office personnel as necessary
  • c. Answer billing line when available to help patients with balances and other issues
  • d. Other duties as assigned.

Excellent Benefits

• Health, Dental, Vision, 401K, Aflac, Health Clinic, Vacation
• PTO - Day 1 of Employment
• Paid Holidays
• Family friendly atmosphere

Salary commensurate with experience.