This position in located in our Springfield, Virginia office

JOB SUMMARY:

The is responsible for verifying insurance benefits, obtaining, reviewing, and accurately determining that all medical documentation received from physicians or referral sources meet all payor and regulatory requirements. The Referral Specialist is responsible for the pre-authorization functionality.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

Include the following as well as other duties and responsibilities, which may be assigned.

1. Examine documents to verify required compliance, completeness, and accuracy of data.

2. Confer with document originator and approvers to resolve identified discrepancies.

3. Contact insurance companies to confirm insurance coverage and eligibility of products.

4. Obtain prior authorization and/or referrals.

5. Appropriately update customer database when obtaining coverage, documents, and pre-authorizations.

6. Appropriately update document databases and corresponding files.

7. Generate communication to the appropriate personal on new and revised documents including pre-authorization request.

8. Regularly communicate with Healthcare Professionals, Regional Sales Managers, and payors.

9. Achieve defined Service Level Agreements.

10. Communicate Payor requirements as they are discovered.

11. Adheres to all HIPAA guidelines/regulations.

12. Follows company policies and procedures.

QUALIFICATIONS:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily and must possess the ability to: Build strong relationships and interact professionally and ethically with patients, caregivers, RSM’s and Healthcare Professionals; handle multiple tasks simultaneously; provide clear, concise oral and written directives/communications; quickly assess situations and respond appropriately; handle special requests in a sensitive, professional manner. Strong Perform strong organizational and time management tasks. Have detail-oriented work product. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

QUALIFICATION REQUIREMENTS:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

EDUCATION AND/OR EXPERIENCE:

High School Diploma or equivalent work experience.

Basic understanding of payor guidelines.

Analytical skills required, attention to detail, and organization.

2+ years of work experience

Previous DME experience a plus.

Basic Microsoft skills.

Ability to work well in a team environment

Job Type: Full-time

Pay: From $1.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Employee assistance program
• Employee discount
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Retirement plan
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Ability to commute/relocate:

• Springfield, VA 22150: Reliably commute or planning to relocate before starting work (Required)

Application Question(s):

• What is your salary history and desire?
• Why are you the best candidate for this opportunity?

Experience:

• Insurance verification: 4 years (Required)
• Medical billing: 1 year (Preferred)

Work Location: One location

Please Note :
www.bankofmontserrat.ms is the go-to platform for job seekers looking for the best job postings from around the web. With a focus on quality, the platform guarantees that all job postings are from reliable sources and are up-to-date. It also offers a variety of tools to help users find the perfect job for them, such as searching by location and filtering by industry. Furthermore, www.bankofmontserrat.ms provides helpful resources like resume tips and career advice to give job seekers an edge in their search. With its commitment to quality and user-friendliness, Site.com is the ideal place to find your next job.