Insurance Specialist
Rish Enterprises
- Scarborough, ME
- Temporary
- Full-time
- Prioritizes work load to ensure all patients are contacted prior to their exam and those with largest responsibility to pay are given highest priority
- Determines if patient's insurance is a part of the provider network
- Makes outgoing calls to insurance companies for pre-certification or any authorization
- Receives pre-authorization from patients and/or insurance companies and documents
- Contacts patient and referring offices using HIPAA guidelines prior to scheduled exam when additional insurance information is needed
- Accurately enters a variety of information including date schedule requests received, patient name, referring physician and procedures into computer system
- Maintains positive interactions with referring offices, patients and staff
- Backs up front desk reception and scheduling area as needed
- Completes payor-related information i.e., payor, payor class, date of appointment
- Obtains all workers compensation approvals from insurance companies prior to scheduled exam
- Obtains signs and symptoms in order to support medical necessity
- High school diploma or equivalent
- 1-2 years previous health care experience working with a variety of health insurance plans for pre-certification and authorization of benefit coverage
- Prior experience with managed care and physician office scheduling
- Microsoft Office Suite Experience
- Proficient with using computer systems and typing
- Bilingual