Insurance Verifier, Billing And Refund Coordinator Specialist And Trainer
Current• Performs telephonic support for online authorization of routine services.• Provides direct support to Primary Care practices and specialty care providers regarding utilization, authorization, and referral activities.• Becomes proficient in the use of ICD-10 and CPT codes.• Data entry referrals for non-complex services including inpatient and outpatient care.• Provides data entry for care which has been arranged.• Contacts providers with authorization, denial, and appeals process information.• Assists in educating and acts as a resource to primary care practices and specialty care providers.• Determines member benefit coverages.• Works closely with all departments to obtain proper approvals for each refund being ordered.• Researches and audits refund amount being requested and rejects any refund requests not in compliance with company’s policies and procedures.• Full control and knowledge of current refund policies and regulations.• Responsible for processing patient data, treatment records and related insurance information.• Processes billing codes in accordance with patient’s diagnosis along with request for payments from insurance companies.• Trains all new employees and coaches them throughout periodically.• Performs other duties as needed.