Job Information
Robert Half Insurance Follow-Up Specialist in Louisville, Kentucky
Description We are seeking an Insurance Follow-Up Specialist based in Louisville, Kentucky. This role involves working with third-party payers and healthcare providers to ensure the timely and accurate completion of pre-authorizations for physician services. The right candidate will be adept at performing insurance and benefit verification as part of obtaining prior authorizations for patient services.
Responsibilities:
• Review, evaluate, verify, and process clinic pre-certification requests for Inpatient, Outpatient, and other clinic procedures.
• Establish contact with insurance companies for pre-certification, ensuring this is done well in advance of the patient's scheduled procedure.
• Utilize basic coding knowledge and proficiency in medical terminology to translate orders into appropriate CPT and Diagnosis information for third-party payers.
• Coordinate with providers to arrange peer-to-peer review with third-party payers or find suitable alternatives for tests or procedures that do not meet prior authorization requirements.
• Work collaboratively with third party payers to obtain all necessary information to complete a prior authorization.
• Enter all prior authorization information into the scheduling and billing system accurately.
• Provide assistance to clinics in obtaining prior authorizations for emergency admits and for patients needing same day clinic visit/hospital admit/procedure.
• Ensure all necessary information needed to properly perform and identify billing information is available and maintained in compliance with institutional, state, and federal practices.
• Verify patient eligibility and prior authorization requirements through online verification software or by telephone and follow up with third-party payers promptly.
• Maintain open lines of communication with clinic personnel.
• Assist in training new employees of the prior authorizations team.
• Provide coverage for other team members as needed. Requirements • Possess a minimum of 1 year of experience in the role of an Insurance Follow-Up Specialist or similar
• Proficient in the use of CPT (Current Procedural Terminology) codes
• Knowledge and understanding of ICD-10 (International Classification of Diseases, 10th Revision) codes
• Demonstrated experience with Prior Authorizations in a healthcare or insurance setting
• Excellent communication and interpersonal skills
• Strong analytical and problem-solving abilities
• Ability to work independently and as part of a team
• Detail-oriented with a high level of accuracy in work output
• Ability to manage multiple tasks and priorities in a fast-paced environment
• Proficient in the use of Microsoft Office Suite and other relevant software applications
• Demonstrated commitment to providing excellent customer service.
Robert Half is the world’s first and largest specialized talent solutions firm that connects highly qualified job seekers to opportunities at great companies. We offer contract, temporary and permanent placement solutions for finance and accounting, technology, marketing and creative, legal, and administrative and customer support roles.
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All applicants applying for U.S. job openings must be legally authorized to work in the United States. Benefits are available to contract/temporary professionals, including medical, vision, dental, and life and disability insurance. Hired contract/temporary professionals are also eligible to enroll in our company 401(k) plan. Visit roberthalf.gobenefits.net for more information.
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