AUTHORIZATION SPECIALIST
- Verifies insurance eligibility and plan benefits.
- Contacts patients with inactive insurance coverage to obtain updated insurance information
- Validates coordination of benefits between insurance carriers.
- Explains insurance plan coverage and benefits to patients, as necessary.
- Secures insurance authorizations and pre-certs for patient services both internal and external to Cooper.
- Creates referrals for patients having a Cooper PCP. Contacts external PCPs to obtain referrals for patients scheduled with Cooper providers.
- Refers patients with less than 100% coverage to Financial Screening Navigators.
- Identifies copayment, deductible and co-insurance information.
- Collects and processes patient liability payments prior to service.
- 2 years insurance verification or registration experience in a hospital or physician office preferred.
- Working knowledge of medical insurance plans & products, coordination of benefits guidelines, and requirements for authorizations, pre-certifications and referrals preferred.
- Proficiency in working with payor on-line portals, as well as NaviNet, Passport or other third party eligibility systems preferred.
- Experience working in a high volume call center preferred.
- Proficiency in IDX Flowcast, Imagecast, and EPIC EMR systems preferred
- High School Diploma required
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