Under general supervision, perform routine and some advanced administrative duties requiring general knowledge of insurance verification policies and procedures.
- Contact insurance companies and utilize online tools to verify insurance benefits for outpatient and inpatient visits at the Child Development Center.
- Complete and process prior authorizations as directed. Monitor number of patient visits per authorization. Complete pre-certifications.
- Perform data entry of billing information into Epic.
- Answer and resolve telephone inquiries regarding billing and insurance issues.
- Assist callers with inquiries requesting estimates for services.
- Advise providers regarding insurance changes and be familiar with CPT, DSM-5 and ICD-10 coding.
- Coordinate self-pay arrangements for patient families.
- Monitor monthly patient activity reports.
- Receive and verify new patient referrals from PCPs. Contact provider or parents to assist with CDC referral process.
- Provide assistance as needed to the Patient Scheduling Reps.
- Perform other duties as assigned.
Full-time role with expectations for coverage during core business hours and flexibility required as necessary to accommodate business needs.
Appropriate education and/or experience may be substituted on equivalent basis
Minimum Required Education: High school diploma
Minimum Required Experience: 1 year
Preferred Experience: Previous experience with medical billing and coding
Knowledge – Skills – Abilities
Knowledge of quality control, customer service standards, information management, procedural process, and recordkeeping. Knowledge of medical billing and coding including CPT, DSM-5 and ICD-10. Computer, technical, interpersonal, oral communication, listening, and patience skills.
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