Beth Israel Lahey Health - Needham, MA
posted 3 days ago
About the position
Provides administrative support to the outpatient specialty clinics. Verifies insurance eligibility, benefits, referral and authorization requirements for the Clinics. Ensures all exams requiring a Prior Authorization and/or Referral are coordinated through the appropriate insurance provider or intermediary, and documents in electronic medical record. Requires knowledge of CPT codes and ICD-10 codes. Provides administrative support for physicians by answering and screening telephone calls, and taking accurate messages. Schedules patient surgeries, coordinating and communicating with other hospital staff as needed. Types correspondence, manuscripts and documents that may require complex formatting. Checks in patients in CCC as needed. Schedules office appointments and imaging exams as necessary. Manages physician billing as needed. The highest regard for patient confidentiality is an expectation at all times. Acts in a professional manner and puts patient needs first.
Responsibilities
- Secures all required prior authorizations and documents in OMR.
- Makes follow up calls to prior authorization agents as needed to ensure timely turnaround of prior authorization documentation.
- Completes forms including disability, back to work and FMLA for patients.
- Responsible for interviewing patients or their representative, obtaining personal information or verifying information already on file, including emergency numbers, next of kin, employer and insurance information.
- Secures all referrals for outpatient clinic visits and documents in OMR, may include medical clearance, physical therapy, etc.
- Prepare all medical records, as requested from attorneys and set up all peer to peer reviews for Physicians, as needed.
- Secures approval for surgery and ensures medical clearance prior to surgery.
- Schedules patient surgeries, including worker's compensation surgeries, coordinating and communicating with other hospital staff as needed.
Requirements
- High School diploma or GED required.
- 0-1 years related work experience required.
- Ability to work independently with minimal supervision.
- Exhibits excellent customer service.
- Experience with computer systems required, including web based applications and some Microsoft Office applications which may include Outlook, Word, Excel, PowerPoint or Access.
Nice-to-haves
- Minimum of 3 years to 5 years in a hospital financial setting, or clinical setting.
- Understanding of hospital collections a plus.
