The Patient Affairs Specialist verifies coverage, benefits and obtains prior authorization or predetermination for upcoming surgeries, procedure and radiology services while demonstrating exceptional customer service skills in interactions with patients, providers, BCM staff, insurance companies, and all other parties.

Job Duties

• Financially clears patients for upcoming services.
• Verifies coverage and benefits for upcoming services.
• Submits authorization requests and performs follow ups.
• Pulls appropriate clinical documentation for case submission.
• Communicates status updates to MD office representatives and patients.
• Creates estimates and collects patient out of pocket prior to services being rendered.
• Answers Insurance Verification Helpline and resolves insurance inquiries from patients, physicians, and departments.
• Investigates patient insurance coverage and demographic issues.
• Accurately documents all work efforts in patient's chart.
• Corresponds with insurance companies to review denied services and provide recourse for payment.
• Assists with STAT verification requests in a timely manner.
• Performs other job related duties as assigned.

Minimum Qualifications

• High school diploma or GED.
• Two years of relevant experience.

Preferred Qualifications

• Three years of relevant experience.
• Prior authorization experience.
• Understands high-level multi-specialty services.
• Epic experience.
• Authorization submission and follow up experience.
• MD office experience.