Access Coordinator, Outpatients Support Services

Job Description

Verification of insurance coverage utilization different on-line modalities for clinic patients receiving diagnostic testing (i.e. CT, MRI, etc.),along with chemotherapy and radiation therapy and/or surgical procedures. The associate is responsible for obtaining prior authorization requests and/or pre-determination for these services to ensure maximum reimbursement to the organization.

Responsibilities

Insurance Verification - Initiates on-line verification and/or makes phone contact with Insurance Carriers and Plan Administrators to verify patient benefits to precert all outpatient services are secure.. Ensures authorization has been obtained for all scheduled and non-scheduled high dollar outpatient procedures. Follows up on missing data or problem accounts. Documentation - Documents complete and accurate data relating to all necessary eligibility, benefits and precertification information in appropriate Epic database fields. Informs management of trends of incomplete data, registration issues, etc. Worklists - Effectively organizes prioritization of Daily Worklist task. Secure Accounts - Secures all applicable accounts in timely manner as defined by Due Diligence Standard while maintaining department productivity and quality standards. Communication - Reports improvements, problems and changes as it relates to insurance verification to department management. Other duties as assigned - Performs other duties as assigned.

Qualifications

Education Requirement: GED/High School Diploma