Job Information
Insight Global Patient Authorization and Referral Representative in Spokane Valley, Washington
Job Description
Verifies insurance benefits and eligibility on all new referrals.
Performs monthly verification of DSHS coverage for long term Medicaid patients and weekly verification for capitated Hospice patients.
Assist in evaluation of documentation to determine if patient meets criteria for coverage of therapy.
Gather necessary information to assure accuracy and completeness of forms and reports; Work with management and staff to correct omissions, errors, office systems problems, etc.
Responsible for creating Cost Disclosure/Advance beneficiary notices for Medicare patients and tracking for signed form.
Responsible for generating benefits letter to inform patient/responsible party of financial responsibility and sending to patient.
Responsible for entering new patient and physician date into the software database, including new therapy sessions on existing patients; Enter ICD-9/ICD-10 codes as needed.
Obtain PCP referral request and follow-up.
Document appropriately in patient electronic record regarding payer/billing information.
Obtain initial pre-authorizations as required by insurance plans.
Verification of physician licensure on an ongoing basis.
Support and incorporate Sisters of Providence Health System Mission into daily activities.
Participate in QA/QI.
Responsible for performing Medicare Part D eligibility and drug formulary checks.
Prepare hospital charity agreements and send and track patient financial assistance applications.
We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com .
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Skills and Requirements
Experience in medical office setting
Reimbursement experience
experience with verification of insurance benefits null
We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal employment opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment without regard to race, color, ethnicity, religion,sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military oruniformed service member status, or any other status or characteristic protected by applicable laws, regulations, andordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or the recruiting process, please send a request to HR@insightglobal.com.