Insurance Verifier

Location: Steward Medical Group - North

Posted Date: 8/27/2024

Job Type: Full Time

Department: 1107.72070 Hawthorn Business Office

Are you looking for an exciting, professional career with a company that treats each individual with dignity and respect? We take pride in our work and organization, knowing that we each make a difference in the lives of our patients every day!

Hawthorn Medical Associates is looking for an enthusiastic, dedicated Insurance Verifier.

The successful candidate will:

1. Verify insurance benefits and obtain prior authorization for patient exams being performed at Hawthorn Medical/SMG.

1. Record all insurance benefits and certification information in the applicable computer system. Complete and distribute all paperwork required by the insurance and imaging departments.

1. Gather all necessary information from secretaries to obtain pre-authorizations and pre-certifications as stipulated by each individual health plan for Diagnostic Imaging services and communicate with scheduling when additional information is required.

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1. Interface on a daily basis with insurance carriers, individual insurance provider authorizers, medical groups, and scheduling coordinators to maximize efficiency.

1. Follow company/department policies and procedures as well as compliance standards.
2. Notifies management staff when problems arise.

1. Provide scheduling services, maintains communication with the ordering physicians and their secretaries to schedule patients for a variety of imaging procedures.

1. Be knowledgeable regarding the appropriate exam preparation, appointment arrival time and contraindications. Able to communicate these instructions to both the scheduling secretaries and the patients that may call directly.

1. Utilize payer websites to determine eligibility and benefit determination to ensure radiology exams are covered and to prevent denials.

Qualifications:

A high school diploma or equivalent required, an associates degree or secretarial certificate preferred. Minimum of 24 years experience in a medical office setting required; medical terminology and computer skills preferred.

Excellent customer service /communication skills.

Detailed knowledge of third party payer requirements for authorization requirements to facilitate payment for imaging services.

Familiar with medical terminology, ICD-10 coding and CPT procedure codes preferred

The ability to process multiple tasks in an ever-changing environment and prioritize workload effectively. Must be able to function independently.

We offer:

Competitive compensation and benefits programs, educational reimbursement and more!

Convenient South coast location, convenient to I-195, free parking

Hawthorn Medical Associates, an affiliate of Steward Health Care, was established in 1970 and is the largest multi-specialty group practice in the Greater New Bedford area. We have many of the areas finest physicians who practice in our state-of-the-art facilities in a campus-like setting. They are supported by a skilled professional support staff, and together provide high quality, comprehensive medical care to more than 138,000 patients each year.

For more information, visit steward.org