Authorizations & Benefit Verification Representative Position Available In Muscogee, Georgia

Authorizations & Benefit Verification Representative SBD Medical Solutions Inc – 2.0

Columbus, GA Job Details Estimated:

$30.4K – $38.8K a year 1 day ago Qualifications Mid-level High school diploma or

GED HCPCS

Medical billing CPT coding Time management

Full Job Description Description:

Southeastern Cardiology Associates, Southeastern Gastroenterology Associates, and SBD Medical Solutions strive to deliver the best care possible through a team approach. From check-in to check-out, each employee participates in delivering the highest quality of care and attention in the Southeast. Our commitment to our patient is that we will treat them like family. We are compassionate and considerate. We are passionate about advancements in technology and patient care. We are educators and good listeners. We believe that qualified specialty care is not hard to find. However, we think that embedding a world-class group of specialists within a team that is committed to treating the patient and their loved ones is what truly sets us apart. Our job is not done when the condition is diagnosed and treated appropriately. We consider the mission accomplished when we have treated the problem and our team has communicated effectively with the patient and their loved ones. Above all, we are here to serve our patients and their families. Our team of specialized physicians, mid-levels, nurses, technicians, and staff are committed to providing the highest level of service – this team approach truly sets us apart. Responsibilities Pre-Certifications/Pre-Authorizations & Benefits Review for office visits and add-on in-house testing. Work pre-authorization schedule at least a week in advance of patient appointment Pull schedule daily for each test that is performed in the office (including but not limited to: nuclear, echo, vascular, Holter, CPET & INR) Check benefits for all patients who have Medicare. Contact customer service representative for all other (non-Medicare) insurances; get benefits and authorization online or over phone, if required. Place all appropriate notes in EClinicalWorks, attached to the visit (which will in turn attach to the claim). Run add-on report multiple times daily to catch any that fall through. (Add-ons will be sent from SEC staff) Benefits & Office Visit Verification Work each office visit schedule at least a week in advance for each provider Obtain and attach referrals to the appropriate visit Determine the amount to be collected based on benefits and previous balances Flag accounts appropriately as necessary (i.e.: referral required, balance due, needs new demographics, etc.) Run add-on report to check for any additional visits that have been scheduled since working the original schedule Initial Review of Denials for Authorization Issues Contact self-pay or lapsed insurance patients at least 5 working days in advance of their appointment to obtain new/valid insurance or provided the cost of the visit Annotate all data in the patient’s chart, payments needed are to be put in Billing Alerts Maintain exceptional communication with front desk, check out and the call center to ensure patients are well informed of their monetary responsibility prior to being seen. Monitor add-on list multiple times daily to ensure no add-on appointments are overlooked Scan documentation (Approvals for visits) into the patient’s chart for prompt billing

Requirements:

Education and Qualifications High school graduate or GED equivalent Pre-certification experience preferred Insurance billing and/or coding experience preferred Maintains knowledge of current regulations and policies for the federal, state and private payers Maintains knowledge of CPT and HCPCS codes Job knowledge and skills Demonstrates the ability to achieve accuracy and consistency Applies knowledge to produce “clean claims” Monitors unbilled accounts and/or uncoded encounters to reduce any billing delays Applies knowledge of regulatory mandates and reporting requirements Corporate Culture Expectations Demonstrates the office Corporate Culture at all times with colleagues, providers, outside offices/vendors, patients, and patient’s family members. Consistently portrays a positive attitude; excels in individual role while creating a culture of teamwork and cooperation; puts the patient/family first and regularly seek opportunities for self-improvement as well as operational improvement. Core Competencies Approachability, Compassion, Customer Focus, Dealing with Ambiguity, Decision Quality, Ethics & Values, Integrity & Trust, Motivating Others, Peer Relationships, Drive for Results, Listening Functional Competencies Composure, Listening, Organizing, Patience, Problem Solving, Technical Learning, Time Management, Understanding Others `