Verifies patients’ insurance benefits and information, as well as obtains pre-authorizations from third party payers in accordance with payer requirements, and/or initiates notifications of admission
Resolves authorization denials by providing additional information, documentation, and appeals
Completes retro-authorizations for urgent and add-on cases as allowed by insurance providers
Documents all payer communications and pre-service financial conversations, including payer decisions, collection attempts, and payment plan arrangements
Provides patients with personalized estimates of their financial responsibility based on their insurance coverage or eligibility for government programs prior to service for both inpatient and outpatient services
Informs patients of the timeframe for enrolling a newborn in coverage, provides any documentation or guidance for the patient to enroll their child prior to or after the anticipated delivery date
Communicates as needed with registration staff and financial counselors
Reports all identified compliance risks to appropriate leadership
Other duties and responsibilities as assigned
Requirements
Two years of appropriate work experience that would indicate a high level of communication skills and knowledge of the modern revenue cycle
Broad Knowledge of Government Programs and Insurance Regulations
US Work Authorization required
Proficiency with Microsoft office suite (Excel, Word, PowerPoint, Outlook, Visio, SharePoint)
Ability to pay close attention to details; strong follow-up and follow-through skills
Requires the use of independent judgment, discretion and decision making abilities
Ability to interact with internal and external customers in a professional manner
Ability to ramp up on a client’s environment, processes, historical context, and systems to provide support to an engagement as soon as possible
Demonstrates a solid understanding of and adheres to all Huron Healthcare compliance program requirements
May be requested to work overtime and/or weekends to fulfil client requirements
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