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Insurance Verification & Authorizations Representative
Location:
New York, NY
Description:
Creates and modifies authorizations and/or orders for new and existing Members in an accurate and timely matter Insurance Verification determine if Participating in net work or out of Network- confirmed Members Benefits for services being rendered Researches, troubleshoots, resolves authorization and/or order processing issues and discrepancies Completes activities, including but not limited to, inbound/outbound calls, as assigned, faxes and emails Obtains information from internal and external sources. Processes or triages the request via our medical management information system or external sources Coordinates with Providers and Members regarding authorization requests and/or activities Communicates with Care Management, Member Services, Membership and Eligibility and other internal departments regarding Member services, authorization requests and issues Reviews all authorization requests for accuracy and prioritizing based on urgency Documents communication, actions taken and barriers in the Medical Management System as it pertains to the Members Care or request for services Utilizes internal and external systems to verify eligibility and Provider Information such as name, address, fax number, NPI and TAX ID. Conducts follow-up, as necessary, to ensure member satisfaction and successful delivery of service Protects the confidentiality of member information and adheres to company policies regarding confidentiality. Performs other duties and special projects, as assigned Qualifications: Knowledge of CPT and ICD9/ICD10 coding/ Clinical. Understanding of insurance plans, i.e. HMO, POS, PPO Knowledge of Excel and Word Excellent Organizational Skills; Attention to Detail Exceptional Communication Skills Working Knowledge of Insurance Company Operations and Procedures Excellent customer service skills Ability to prioritize work in a fast-paced environment Computer skills Appeals/Retro active request skills Sending Specialty Prescription when needed MRI Authorization Utilization Management Knowledge of Manufacture Co-Pay Assistance Program/Foundation. Powered by JazzHR
Company:
Vitreous-Retina-Macula Consultants Of New York Pc
Industry:
Insurance
Posted:
February 22 on The Resumator
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More About this Listing: Insurance Verification & Authorizations Representative
Insurance Verification & Authorizations Representative is a Insurance Jobs Insurance Agent Job at Vitreous-Retina-Macula Consultants of New York Pc located in New York NY. Find other listings like Insurance Verification & Authorizations Representative by searching Oodle for Insurance Jobs Insurance Agent Jobs.
Insurance Verification & Authorizations Representative is a Insurance Jobs Insurance Agent Job at Vitreous-Retina-Macula Consultants of New York Pc located in New York NY. Find other listings like Insurance Verification & Authorizations Representative by searching Oodle for Insurance Jobs Insurance Agent Jobs.