Insurance Verification Coordinator
Current• Enter and/or update patient demographics, insurance, and benefits into CTM, HCN 360, Med Force, and CPR+.• Verify insurance coverage, calculate costs, and document details in the patient profile.• Medical vs pharmacy benefit determination.• Generate a financial responsibility, ABN and AOB letters.• Review benefits with patients and MDO via phone, mail, and/or fax.• Identify copay, foundation assistance and/or donated drug programs.• Track, monitor and secure necessary insurance and clinical documents.• Obtain prior authorizations as required. Document denials, appeals, and peer to peer procedures.• Coordinate completion of Financial Assistance forms, payment agreements and waivers.• Assist billing with denied claims along with submitting and reversing claims via CE 2000• Assist with training new employees.• Daily use of Epic, NuPay, Diagnosis Search, and SharePoint.• Create new hospital and physician codes as needed.• Physician credentialing: verifying and entering NPI, PTAN, PECOS enrollment, and all other pertinent information for onboarding, intake, and billing purposes.• Give high priority to client satisfaction and customer needs.• Knowledge of J-codes, B-codes, NDC, HCPCS for billing and coding purposes for infusion therapies and medical nutritional formula.• Demonstrates the ability to work effectively and maintain expected productivity.• Assist with researching reimbursement issues.
