Prior Authorizations Rep - Cardiology - East Mesa (22325)
If you are seeking to join a stable and established organization with high employee and patient satisfaction ratings, then Tri-City Cardiology is for you! Tri-City Cardiology has been serving the healthcare needs of the East Valley for 40 years.
We are searching for an Insurance Auths & Referrals specialist to join our dynamic team. If you are passionate about providing the highest level of customer service and patient care, we want to speak with you!
Tri-City Cardiology has a vision "To be among the best providers of cardiovascular care in the entire country and be a place where employees want to work, patients want to receive care and physicians want to practice."
Consistent with our vision, we constantly strive to improve our employee satisfaction. Tri-City Cardiology has been voted a Top Place to Work by the Phoenix Business Journal. Annual employee satisfaction surveys are conducted to obtain feedback on how we can continue to make Tri-City Cardiology the best place to work.
Location: Administrative Office location (Power Rd/US 60)
Schedule: 7am-4pm Monday-Friday January-June and 8am-5pm July-December
This position provides daily support for the financial services of our patients. Incumbents perform daily verification of patient financial information, call patients for notification of out-of-pocket (up-front cash) obligations based upon information provided by the verification process prior to check-in for the visit.
- Verifies patient eligibility with insurance companies and third party vendors.
- Obtains authorizations (MedSolutions, Navinet, AIM, etc.) for office visits, testing, cardiac rehabilitation, and any other outside facility procedure requiring authorizations and/or referral in a timely manner.
- Answers all incoming calls, updating demographic and insurance information.
- Explains TCC’s financial policy to patients and discusses financial responsibilities including co-pays, coinsurances, deductibles and time of service payments. Documents all conversations to assist front office with collections.
- Assists other departments with adding correct insurance information into patient charts.
- Ensures physician documentation supports payer requirements for authorization processing.
- Ensures follow through on peer-to-peer requests. Creates appeal letters when necessary.
- Schedules PET and Nuclear appointments after reviewing financial responsibilities with patient.
- Note: The essential functions outlined in this job description are intended to describe the general content and requirements of the position. They are not intended to be an exhaustive statement of all duties, responsibilities or qualifications associated with the position.
Note: The essential functions outlined in this job description are intended to describe the general content and requirements of the position. They are not intended to be an exhaustive statement of all duties, responsibilities or qualifications associated with the position.
- High school diploma or GED.
- 40 wpm typing
- Demonstrated knowledge of ICD and CPT codes, billing practices and policies/procedures.
- Knowledge of basic computer and math skills.
- Demonstrated critical thinking ability in order to resolve problems and carry out instructions.
- Ability to multi task.
- Excellent verbal communication skills in an effective, clear, calm, friendly and professional manner.
- Ability to effectively communicate to all internal and external customers.
- Manages tasks in a timely fashion.
- Ability to read and interpret documents.
- Two to five years of experience with insurance companies preferred.