Experienced Intake/Verification Specialist - AIS Healthcare : Job Details

Thorough knowledge of the processes for patient insurance eligibility and benefits for a variety of payers to include but not limited to: Aetna, Cigna, BCBS, Humana, Worker's Comp, Medicare, and Medicaid. Specific knowledge of Authorization processes relative to GA - Ps, Pre-determinations, PCP Referrals, and Single Case Agreements. Detailed and accurate entry of insurance and authorization information into EHR systems per Standard Operation Procedures. Completes follow-up on pending or expired authorizations, referrals as assigned. Review authorization denials for accuracy; initiate the appeal process until the case is overturned, appeal options are exhausted, or decision is made to discontinue the process. Documents details of all calls per the Standard Operation Procedures of the department. Timely follow-up and response to all Quality Reviews. Recognizes patients' rights and responsibilities and supports them in the performance of job duties, respects patient's rights to privacy an...Specialist, Intake, Verification, Experience, Healthcare