Job Summary :
The Outpatient Administrative Specialist will provide clinical administrative support to the assigned ambulatory area. May assist in the preparation of monthly report of activities by compiling statistical data relative to clinic services as needed or requested.
Serves as a resource for providers and staff relative to the referral and authorization processes. Assist with patient check-in and check-out procedures including registration activities such as entering and / or verifying demographic, insurance and / or financial information;
generates routine forms and other documentation. Manage the EPIC Referral WQs. Answers phone, prioritizes incoming mail, faxes and correspondence.
Work with / advise patients on insurance carrier requirements including services not covered and obtains documentation, collects patient co-pays, etc.
Applies understanding of the need for ABN's and Waiver of Liability patient signatures. Obtains insurance authorizations, referrals, and manages denial processes in an accurate and efficient manner.
Accepts assignments to other areas and performs additional administrative support duties as assigned.
Minimum Qualifications :
Associate's degree and two (2) years of related patient financial / insurance services experience OR an equivalent combination of education and experience required.
Working knowledge of medical terminology, medical billing / insurance requirements, familiarity with medical coding, and excellent written / oral communication skills required.
Computer skills and keyboarding are necessary. Ability to maintain good public relations with patients, visitors, co-workers and other individuals.
Preferred Qualifications :
Working knowledge of computer systems such as Epic, Word, Outlook, etc. preferred. Prior working experience in ambulatory patient care administrative functions including obtaining referrals and insurance authorizations, managing EPIC referral work queues, communicating with outside agencies such as insurance carriers, billing companies and / or other support agencies preferred.
Knowledge of medical authorizations, billing requirements and the ability to recognize insurance fraud / abuse is strongly preferred.
Ability to multitask in a busy fast pace environment.
Work Days :
Monday through Friday Days rotating 1000-1830 Tuesdays
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