Job Description

With customer service orientation, verifies patient’s insurance benefits and eligibility. Obtains required authorization, provides procedure codes and fee estimates and collects prepayment from patients when appropriate.

REPORTS TO Practice Manager

WHAT WE OFFER:

• Starting wage will be determined based on experience and/or certification
• 6.5 paid holidays per year
• Approximately 10 days of PTO within first year
• Full benefits portfolio to include health, dental, vision, and 401k
• Growth and wage increase through company paid certification program

ESSENTIAL RESPONSIBILITIES:

• Monitor scheduled surgeries and maintain organized list with status of pre-certification process.
• Verify insurance eligibility and benefits via phone and/or internet access. Update insurance policy information in Eyecare as required.
• Check insurance payment policy for scheduled procedures and obtain prior authorization when required.
• Verify receipt of all necessary pre-authorization documents prior to procedure.
• Communicate effectively with the facility in which the procedure will be performed as needed.
• Assign appropriate ICD and CPT codes pre-operatively based on documentation and booking slips.
• Notify primary care physician for managed care plans that require PCP authorization.
• Supply patients with written or verbal estimates of surgical codes and fees upon request.
• Meet with patients pre-operatively or communicate effectively as necessary with patients so they understand the billing process and their financial expectations pre-operatively.
• Collect pre-payment from the patient when necessary.
• Notify patients with past due accounts of pre-payment policy for elective surgery. Receive payments from patients.
• Assist with check-in and check-out when needed. Serve as a resource on insurance, billing and customer service for reception and cashier.
• Monitor cash box and report balance to supervisor and accounting department monthly.
• Perform other duties or functions as assigned.

EDUCATION AND/OR EXPERIENCE

• A minimum of two (2) years experience in the medical field.
• Must have a strong knowledge of anatomy, physiology, medical terminology, and medical insurance.

COMPETENCIES:

• communication skills
• attention to detail
• adaptability
• customer service oriented
• problem solving skills
• integrity
• confidentiality
• decision-making skills
• adaptable to change
• stress tolerance

PHYSICAL DEMANDS AND WORK ENVIRONMENT (per ADA guidelines):

• Physical Activity: Talking, Hearing, Repetitive motion.
• Physical Requirements: Sedentary work. Involves sitting most of the time.
• The worker is required to have visual acuity to determine the accuracy, neatness, and thoroughness of the work assigned.

PERSONAL DEVELOPMENT

• Staff members are required to meet training expectations within the initial 90-day probationary period.
• Obtaining certification in ophthalmic field is encouraged. We will provide assistance to all employees eligible for the Employee Career Development Program.