BusinessOperations - Insurance Verification Coordinator I - Insurance Verification Coordinator I - Mindlance : Job Details

Job Description: Position Purpose: Obtain and verify complete insurance information, including the prior authorization process, copay assistance and coordination of benefits Education/Experience: High school diploma with 1+ years of medical billing or insurance verification experience. Bachelor's degree in related field can substitute for experience. Experience with payors and prior authorization preferred. Strong customer service skills. Responsibilities: • Obtain and verify insurance eligibility for services provided and document complete information in system • Perform prior authorizations as required by payor source, including procurement of needed documentation by collaborating with physician offices and insurance companies • Collect any clinical information such as lab values, diagnosis codes, etc. • Determine patient's financial responsibilities as stated by insurance • Configure coordination of benefits information on every referral • Ensure assignment of benefits are obtained and on file for Medicare claims • Bill insurance companies for therapies provided • Document all pertinent communication with patient, physician, insurance company as it may relate to collection procedures • Identify and coordinate patient resources as it pertains to reimbursement, such as copay cards, third party assistance programs, and manufacturer assistance programs • Handle inbound calls from patients, physician offices, and/or insurance companies • Resolve claim rejections for eligibility, coverage, and other issues Comments for Vendors: EEO: Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of - Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans. Centene Job Description Position Purpose: Obtain and verify complete insurance information, including the prior authorization process, copay assistance and coordination of benefits Education/Experience: High school diploma with 1+ years of medical billing or insurance verification experience. Bachelor's degree in related field can substitute for experience. Experience with payors and prior authorization preferred. Strong customer service skills. Responsibilities: • Obtain and verify insurance eligibility for services provided and document complete information in system • Perform prior authorizations as required by payor source, including procurement of needed documentation by collaborating with physician offices and insurance companies • Collect any clinical information such as lab values, diagnosis codes, etc. • Determine patient's financial responsibilities as stated by insurance • Configure coordination of benefits information on every referral • Ensure assignment of benefits are obtained and on file for Medicare claims • Bill insurance companies for therapies provided • Document all pertinent communication with patient, physician, insurance company as it may relate to collection procedures • Identify and coordinate patient resources as it pertains to reimbursement, such as copay cards, third party assistance programs, and manufacturer assistance programs • Handle inbound calls from patients, physician offices, and/or insurance companies • Resolve claim rejections for eligibility, coverage, and other issues Story Behind the Need

• What is the purpose of this team?
• Describe the surrounding team (team culture, work environment, etc.) & key projects.
• Do you have any additional upcoming hiring needs or is this request part of a larger hiring initiative?

project ascend Typical Day in the Role

• Walk me through the day-to-day responsibilities and a description of the project (Outside of the Workday JD).
• What are the performance expectations/metrics?
• What makes this role unique?

Insurance verification for medication; prior authorization appeals; speak to patients, doctors' offices, & insurance plans Inbound internal que 25 referrals/more a day 95% quality or higher ttendance is crucial Candidate Requirements Education/Certification Required: High school diplom Preferred: N Licensure Required: N Preferred: Years of experience required: 1 + years of expereince Disqualifiers: N dditional qualities to look for: Proficient in Microsoft Office, experience/backgrounds that do well in this role- Managed Care, Pharmacy, Medical terminology, Physician office experience, Customer Service, Call Center

• Top 3 must-have hard skills stack-ranked by importance

1 Managed Care 2 Customer Service 3 Call Center Candidate Review & Selection

• Shortlisting process
• Candidate review & selection
• Interview information
• Onboard process and expectations

Projected Manager Candidate Review Date: 1-2 days post shortlisting Type of Interviews: Teams-camera on Required Testing or Assessment (by Vendor): Next Steps

• dditional background check requirements (List DFPS or other specialty checks here)

• Do you have any upcoming PTO?

• Colleagues to cc/delegate

• re there any training requirements (time off, alternate schedule, etc.)?