Insurance Verifier
Posted on: 3 Jan 2021
North Dartmouth, MA
Job Description
Job Description
Location: Steward Medical Group - North
Posted Date: 12/29/2020
Principal Duties and Responsibilities:
1. Verifies insurance benefits and obtains prior authorization for patient exams being performed at Hawthorn Medical/SMG. .
2. Records all insurance benefit and certification information in the applicable computer system. Completes and distributes all paperwork required by insurance and Imaging department.
3. Gathers all necessary information from secretaries to obtain pre-authorizations and pre-certifications as stipulated by each individual health plan for Diagnostic Imaging services and communicates with scheduling when additional information is required.
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4. Interfaces on a daily basis with insurance carriers, individual insurance provider authorizers, medical groups, and scheduling coordinators to maximize efficiency.
5. Follows company/department policies and procedures as well as compliance standards. Notifies management staff when problems arise.
6. When providing scheduling services, maintains communication with the ordering physicians and their secretaries to schedule patients for a variety of imaging procedures.
7. Knowledge regarding the appropriate exam preparation, appointment arrival time and contraindications. Able to communicate these instructions to both the scheduling secretaries and the patients that may call directly.
8. Utilizes payer websites to determine eligibility and benefit determination to ensure radiology exams are covered and to prevent denials.
Qualifications:
* High school diploma or equivalent required, associate's degree or Secretarial certificate preferred.
* Minimum of 2-4 years' experience in medical office setting required; medical terminology, and computer skills preferred.
Skills and Abilities Required:
Excellent customer service /communication skills.
Detailed knowledge of third party payer requirements for authorization requirements to facilitate payment for Imaging services.
Familiar with medical terminology, ICD-10 coding and CPT procedure codes preferred
Ability to process multiple tasks in an ever-changing environment and prioritize workload effectively. Must be able to function independently.
Carney Hospital
Boston, MA
What Should I Know About Carney Hospital?
Carney Hospital in Dorchester, Massachusetts, has proudly served the City of Boston and neighboring communities since 1863.
Since 1863, Carney Hospital has served the City of Boston and neighboring communities. Carney Hospital has received the Joint Commission’s Gold Seal of Approval for health care quality and safety and numerous other quality and safety awards, including being designated a Top Hospital for 2014, 2015 and 2017 by the Leapfrog Group. The 159-bed hospital has more than 400 physicians and delivers high-quality to our community where they live. Carney Hospital provides Dorchester and surrounding communities with convenient, local access to quality primary care, emergency medicine and a range of specialties and subspecialties including; critical care, family medicine, cardiology, neurology, orthopedics, ambulatory care and adolescent, adult and geriatric psychiatry.
Carney Hospital operates a stand-alone Emergency Room located in the city of Quincy with on-site diagnostic radiology, including CT scans and ultrasound, pharmacy, and laboratory services. Carney Hospital is part of the Steward Health Care Network.
Carney Hospital is a Steward Family Hospital. Steward Health Care is the largest private, tax-paying physician-led health care network in the United States. Headquartered in Dallas, Texas, Steward operates 37 hospitals in the United States and the country of Malta that regularly receive top awards for quality and safety. The company employs approximately 42,000 health care professionals. The Steward network includes multiple urgent care centers and skilled nursing facilities, substantial behavioral health services, over 7,900 beds under management, and approximately 2.2 million full risk covered lives through the company's managed care and health insurance services.
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IndustryHealthcare
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No. of Employees1000+
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Website
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Jobs Posted6388
