Managed Care Representative (Finance)
Make calls to insurance companies for necessary authorization of services for patient appointments
Utilize online services from insurance companies to obtain authorizations and/or gather information regarding patients' coverage for services.
Process all items for review in the practice management system and assigned to the department
Patient Accounts, Billing, Copays and Balances to process for payment
Handle all calls and/or written inquiries regarding appointment service authorizations through resolution
Research, correct and re-file any denied or rejected authorization to maximize reimbursement.
Document all information obtained in the practice management system to adequately relay said information to all staff
Report rules, changes and other information affecting authorizations to the Medical Records Supervisor
Print reports from the practice management system to facilitate authorization for appointment services for previously scheduled patients and patients added on.
Participate in educational and training opportunities to maintain current knowledge of payment policies Organize electronic patient records based on referral status
Fills in for other account representative positions as needed
Performs other duties as required and assigned by the Medical Records Supervisor
Typical Physical Demands
The employee is required to sit for prolonged periods of the time and must be able to use hands and fingers to handle and to feel and arms to reach. The employee must be able to talk on the phone, hear and listen and be understood by the majority of the public. The employee may be occasionally required to stand and walk. The employee must be able to lift/and or move up to 10-15 pounds.
Typical Working Conditions
Work is performed in an office environment. Work involves frequent contact with staff, patients, and the public. Work may be stressful at times. Contact may involve dealing with angry or upset people.