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Talley Eye Institute

Prior Authorization/Insurance Specialist

Career Insights for Medical Claims Processor / Representative

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What they do

A Medical Claims Processor or Representative reviews and processes medical insurance claims and determines whether an insurance policy will cover a medical procedure. Gathers information from policy holders and organizes insurance files; may process checks with payments to policy holders when a medical claim is approved.

$41,298 / year median in Indiana

-8% projected decline

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Job Description

Prior Authorization/Insurance Specialist Talley Eye Institute - 2.7 Evansville, IN Job Details Full-time $19.50 - $21.00 an hour 22 hours ago Benefits Paid holidays Health insurance Dental insurance 401(k) Paid time off Parental leave Vision insurance 401(k) matching Qualifications Medical office experience High school diploma or
GED Full Job Description Benefits:
Health insurance Paid time off Parental leave 401(k) 401(k) matching Dental insurance
POSITION
Insurance Specialist
DEPARTMENT
Billing
REPORTS TO
Billing Manager Job Summary:
This individual is responsible for injection authorization, checking insurance benefits, and out of pocket expenses.
Education and Experience:
1. High school diploma or equivalent. 2. Two years minimum experience in medical office, insurance experience preferred.
Essential Skills and Abilities:
1. Excellent communication skills, written and oral. 2. Strong organization skills with attention to detail. 3. Excellent follow-up skills. 4. Management of multiple tasks simultaneously. 5. Ability to work as a team player.
RESPONSIBILITIES
1.
Injection authorizations:
a. Works with retina technicians and physicians on determining which medications the patient can have vs. which ones will require a sample or prior authorization. b. Performs a thorough benefits investigation on patients when injections are recommended for treatment. c. If needed, obtain prior authorizations for injections by contacting third party payors via fax or other TEI approved methods. d. Heavy phone contact communication. 2. Patient assistance programs a. Work directly with patients and staff to get patients signed up for payment assistance programs, including Good Days, CDF, etc. b. Enroll patients in assistance programs as needed. c. Work with other individuals in RCM department to ensure that patients are not erroneously billed for out-of-pocket expense. 3. Additional Duties a. Work with administration and supervisor to look for ways to make processes work more smoothly and reduce the opportunity for errors in the benefits process. b. Assist front office personnel as necessary c. Answer billing line when available to help patients with balances and other issues d. Other duties as assigned. Excellent Benefits Health, Dental, Vision, 401K, Aflac, Health Clinic, Vacation PTO - Day 1 of Employment Paid Holidays Family friendly atmosphere Salary commensurate with experience.