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Patient Service Representative - Prior Authorization- Nephrology
Springfield Clinic
Springfield, USA
Full-time
Entry · 2+ years experience
Onsite
USD 17.34-25.14 hourly / hour
Discovered 6 days ago
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Patient Service Representative - Prior Authorization is responsible for discussing insurance coverage, including usual and customary charges, Medicare and Medical Assistance availability, reimbursement options available for services, educating patients regarding the Clinic's billing and credit policies, work with patient’s insurance carrier to verify benefits coverage for treatment, and discuss any credit concerns regarding a past due account and make special arrangements if necessary to assure payment will be made in a timely manner.
Job Relationships
Reports to Operations Manager or Director of the service line
Principal Responsibilities
- Verify coverage and benefits prior to treatment.
- Secure prior-approval and pre-authorizations.
- Maintain proficiency with insurance and billing issues and serve as a resource to providers and staff.
- Provide a positive impression to patients about the Clinic's billing department.
- Enter/edit patient insurance coverage/demographic information when necessary.
- Answer questions that patients may have in regard to insurance coverage and other billing issues.
- Respond to patient's verbal and written requests in a timely fashion.
- Maintain statistics.
- Maintain proficiency with insurance and billing issues by participating in Patient Accounting meetings and training sessions as appropriate.
- Must be empathetic, yet responsive to patients while adhering to Patient Accounting billing practices and guidelines.
- Provide coverage at other Springfield Clinic locations as assigned.
- Comply with the Springfield Clinic incident reporting policy and procedures.
- Adhere to all OSHA and Springfield Clinic training & accomplishments as required per policy.
- Provide excellent customer service and adhere to Springfield Clinic's Code of Conduct and Ethics Standards.
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