To accurately obtain insurance eligibility verification information from insurance carriers for PCLI surgical patients, and report the information timely and concisely to that appropriate site patient counselor.
STATUS Part-Time Regular
ORGANIZATION Insurance Eligibility Team Member
Reports to Director of Finance
RESPONSIBILITIES Duties include, but are not limited to:
Using the sites appointment schedule, contact the insurance carrier, via internet, software or phone to verify patient eligibility and inquiry on pre-authorizations or referrals requirements as needed for surgical procedures.
Routinely monitor appointment schedules to identify added appointments in need of eligibility verification.
Become proficient in the use of the eligibility software.
Communicate with the site patient counselors the verification information obtained, and provided notices of needed referral or authorizations if applicable.
Communicate directly with insurance companies to clarify procedure eligibility issues.
Respond to site phone calls and email requests to confirm patient eligibility status, and resolve their concerns.
Understanding of CPT and ICD coding.
Maintain confidentiality of all department, patient and provider information.
