About us
We are professional and fast-paced.
Responsible for obtaining benefit information and preapproval from insurance companies for speech-language, and hearing services before they are provided to patients.
Primary duties include:
1. Verifying Insurance Benefits and Requirements
· Review patient insurance plans to understand coverage, deductibles, copays, and prior authorization requirements for specific treatments or services.
· Contacting insurance companies to verify benefits and obtain necessary authorizations.
· Works with third-party vendors to secure authorization benefits for patients
2. Processing Prior Authorization Requests
· Gathering relevant medical documentation, such as clinical notes, test results, and treatment plans to support prior authorization requests.
· Submitting prior authorization requests to insurance companies via Availity, insurance web portals, or phone and following their specific procedures and guidelines.
· Prioritizing and managing a queue of authorization requests based on urgency and scheduled appointment dates.
3. Follow-up and Appeals
· Regularly following up with insurance companies on pending authorization requests to ensure timely approvals.
· Initiating appeals for denied authorizations by providing additional supporting documentation and rationale.
4. Documentation and Coordination
· Maintaining accurate records of all authorization requests, approvals, denials, and appeals in the patient’s electronic medical record system.
· Coordinating with healthcare providers and billing staff to ensure accurate coding and billing for authorized services.
· Educating patients on insurance requirements, out-of-pocket costs, and the prior authorization process.
· Create and provide “Good Faith Estimates” for patients
· Monitor the accrued sessions and alert providers as approved sessions are expiring
· Monitor dates of Plans of Care for active patients and alert providers as end dates are approaching
5. Obtains referrals from primary care physicians for new and continuing patients, as needed
6. Is familiar with and maintains HIPPA compliance regarding all patient information.
7. Assists the administrative team as requested.
8. Cross-train with the receptionist and provide backup as needed.
Skills and Qualifications:
· Knowledge of medical terminology, coding systems (CPT, ICD-10), and insurance policies and regulations.
· Strong communication skills for interacting with insurance companies, healthcare providers, and patients.
· Attention to detail and organization skills to manage multiple authorization requests and deadlines.
· Proficiency in email, computer applications, and electronic medical record systems.
· Ability to multitask, and work efficiently and independently in a fast-paced environment
· Must be able to keep all patient records and information confidential.
Preference may be given to applicants with an Associate’s degree or medical billing/coding certification.
Job Type: Part-time
Pay: $18.83 - $20.42 per hour
Expected hours: 20 – 25 per week
Benefits:
Weekly day range:
Work setting:
Ability to Commute:
- Bristol, VA 24201 (Required)
Ability to Relocate:
- Bristol, VA 24201: Relocate before starting work (Required)
Work Location: Hybrid remote in Bristol, VA 24201