Insurance Clerk-985

Insurance Clerk-985

Utilizes online systems, phone communication, and other resources to determine eligibility and benefits, extent of coverage, pre-certification / authorization requirements, and other limitations within a timeframe before scheduled appointments. Obtains pre-certifications from third-party payers in accordance with payer requirements.

Verifies medical necessity in accordance with the Centers of Medicare and Medicaid Services (CMS) standards, and communicates relevant coverage and eligibility information to the patient.

Alerts physician offices and patients with issues regarding insurance eligibility and prior-authorization requirements.

Promotes positive interactions with patients, physicians, and coworkers- providing exceptional customer service at all times.

Ability to work in an ever-changing environment.

Ability to work schedule as assigned and work flexible shifts. Ability to arrive to work on time as work schedule dictates.

Performs any and all other job duties as assigned.