Coor- Access

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 - 60% 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 - 20% 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 - 5% Effectively organizes prioritization of Daily Worklist task. Secure Accounts - 5% Secures all applicable accounts in timely manner as defined by Due Diligence Standard while maintaining department productivity and quality standards. Communication - 5% Reports improvements, problems and changes as it relates to insurance verification to department management. Other duties as assigned - 5% Performs other duties as assigned | Review the physical demands and assign an overall average percentage of time this position performs these activities. These physical demands will not be listed or rated on the annual performance appraisal. Climbing: Ascending or descending stairs, ladders, ramps, etc, using feet and legs and /or hands and arms - 0% Stooping: Bending body downward and forward by bending spine at the waist - 5% Kneeling: Bending legs at knees to come to a rest on knee or knees - 5% Reaching: Extending hand(s) and arm(s) in any direction - 10% Standing: Remaining upright on the feet, particularly for sustained periods of time - 10% Walking: Moving about on foot to accomplish tasks - 15% Pushing 0-10 lbs: Use of upper extremities to press against something with steady force in order to move something forward, downward or outward - 10% Pushing 11-20 lbs: Use of upper extremities to press against something with steady force in order to move something forward, downward or outward - 0% Pushing 21-50 lbs: Use of upper extremities to press against something with steady force in order to move something forward, downward or outward - 0% Pushing 51 lbs or more: Use of upper extremities to press against something with steady force in order to move something forward, downward or outward - 0% Pulling: Use of upper extremities to exert force in order to drag, haul or tug objects in a sustained motion - 10% Lifting 0-10 lbs: Raising objects from a lower to a higher position, or moving objects horizontally from position-to-position and requires the use of upper extremities and back muscles - 10% Lifting 11-20 lbs: Raising objects from a lower to a higher position, or moving objects horizontally from position-to-position and requires the use of upper extremities and back muscles - 0% Lifting 21-50 lbs: Raising objects from a lower to a higher position, or moving objects horizontally from position-to-position and requires the use of upper extremities and back muscles - 0% Lifting 51 lbs or more: Raising objects from a lower to a higher position, or moving objects horizontally from position-to-position and requires the use of upper extremities and back muscles - 0% Carrying 0-10 lbs: Holding and moving/transporting an object about - 10% Carrying 11-20 lbs: Holding and moving/transporting an object about - 0% Carrying 21-50 lbs: Holding and moving/transporting an object about - 0% Carrying 51 lbs or more: Holding and moving/transporting an object about - 0% Fingering: Picking, pinching, typing or otherwise working primarily with fingers rather than with the whole hand or arm, as in handling - 60% Feeling: Perceiving attributes of objects such as size, shape, temperature or texture by touching with skin, particularly that of (using) fingertips - 0% Talking: Expressing or exchanging ideas by means of the spoken word - must convey detailed or spoken instructions to others accurately, loudly or quickly - 80% Hearing: Perceiving the nature of sounds at normal speaking levels with or without correction, and having the ability to receive detailed information through oral communication - 100% Seeing: The process of perceiving objects by use of the eyes to perform an activity - visual acuity requirements include ability to discern position of object(s), shape of object(s), color, depth perception or visual inspection - 100%

Qualifications

Minimum Required: Associate's Degree - Respiratory Therapy ? Preferred Degree: N/A | Current Basic Life Support for Healthcare Provider certification required ? Graduate of a CoARC approved respiratory care program ? Registered Respiratory Therapist (RRT) | Minimum Required: 2 Years equivalent experience - Critical Care ? Preferred: 3 - 5 Years equivalent experience