Job Summary:

The Insurance Verification, Referral & Authorization Specialist II is responsible for verifying health insurance benefits for all new patients or existing patients. This position will contact the patient's insurance company to verify coverage levels and works with patients to walk them through their benefits information. The position works to ensure that patients have been authorized for specialty services and office visits. May act as a liaison between the patient, provider/referring provider, primary care provider, and other parties involved in the plan of care. Appropriately link referrals for identified visits.

Job Responsibilities:

• Verify patient insurance coverage.
• Update patient benefit information in EMR.
• Perform routine administrative and clerical tasks.
• Perform administrative duties, including answering telephones, and greeting patients.
• Assist patients in gaining appropriate physician, hospital, and medical referrals.
• Process preauthorization forms for requests in the physician’s office or provider.
• Link referrals for identified visits.
• Process patient referrals and insurance forms.
• Perform related duties as assigned.
• Responsible for assisting with more complex patient issues and concerns.
• Complete referrals and authorization for more complex visit types (e.g. major surgery).
• Act as a point of escalation and monitor supervisory or secondary work queues.

Job Qualifications

• A high school graduate or GED certificate is required.
• A minimum of 1-year experience in a physician billing or third-party payer environment.
• Candidate must demonstrate working knowledge of contracts, insurance benefits, exclusions, and other billing requirements as well as claim forms, HMOs, PPOs, Medicare, Medicaid, and compliance program regulations.
• Candidate must demonstrate the ability to understand and navigate the payer adjudication process.
• Candidate must demonstrate strong customer service and patient-focused orientation.
• Must demonstrate effective communication skills both verbally and written.
• Functional proficiency in computer software skills (e.g. Microsoft Word, Excel and Outlook, E-mail, etc.)
• Patient financial and practice management system experience in Epic and or other electronic billing systems is preferred.
• Knowledge of medical terminology is preferred.
• Previous experience in an academic healthcare setting is preferred.

Hourly Rate Ranges: $22.78 - $30.77

Note: Our salary offers will fall within these ranges based on a variety of factors, including but not limited to experience, skill set, training and education.

61st Street Service Corporation

At 61st Street Service Corporation we are committed to providing our client with excellent customer service while maintaining a productive environment for all employees. The Service Corporation offers a competitive comprehensive Benefit package to eligible employees; including Healthcare and various other benefits including Paid Time off to promote a healthy lifestyle.

We are an equal employment opportunity employer and we adhere to all requirements of all applicable federal, state, and local civil rights laws.