Insurance Coordinator (Healthcare)

Insurance Coordinator
The Insurance Coordinator is responsible for verifying insurance and managed care plans to determine patient eligibility across all listed insurance providers. They handle authorizations submissions and follow-ups, ensuring approval for necessary treatments and documenting outcomes in patient accounts. Additionally, they directly contact patients regarding insurance discrepancies and obtain referrals as per insurance plan requirements, while maintaining data integrity protocols in managing insurance records. The Insurance Coordinator also serves as a key resource for staff, answering authorization questions, updating them on insurance plan changes, and ensuring accuracy in patient balances for upcoming appointments.

Duties / Responsibilities
Verifies insurance/managed care plans for eligibility for all insurance plans listed in the patient accountHandles Authorizations submissions and follow-ups for all assigned insurance payors to confirm eligibility and/or contacts the payer directly and documents the outcome in the patient accountContacts patients directly when insurance has terminated or shows ineligible in attempts to obtain current information prior to office visitsWill pre-certify all patient testing, procedures, and injections by confirming their insurance/managed care plan eligibility in addition to confirming whether prior authorization for visits and treatments are necessaryEnter referrals/authorization information into Practice Management softwareObtains and/or advises patients of the need for referrals as indicated on their insurance plan, i.e., BCBS, Aetna, Oxford, HIP, and/or HCPObtains all Healthcare Partners referrals for existing patients providing all clinical documents, as necessaryFollow and maintain data integrity protocols in adding/editing patients insurance recordsAnswers authorization questions and requirements for all payers to assist clinical and front office staffAdvises staff of any insurance plan updatesChecks patient balances on upcoming appointments for accuracy and presents to the front desk to collectPerform other duties as required