Assist the clinic's patients with obtaining proper authorizations for all Third Party patients. Ensure patients are eligible for Third Party insurances. Verify and maintain the billing episodes for each third party patient in Methasoft.
➢ Verify patient insurance eligibility, weekly or monthly based on state requirements.
➢ Obtain treatment authorizations when needed from Medicaid or other state programs in a timely manner; regularly updating Methasoft with correct billing episodes and authorizations.
➢ Process authorization requests in a timely manner.
➢ Assists Program Director and patient with patient reimbursements.
➢ Communicates with patients to obtain the required information in order for corporate billing to submit claims timely.
➢ Communicates with clinic staff concerning patient inquiries related to initial billing and third party insurance matters.
➢ Review lab invoices a minimum of twice monthly and make necessary adjustments for billing.
➢ Procure Authorizations for services prior to rendering.
➢ Communicate, daily, any work-related issues, challenges, questions and concerns with assigned AR Coordinator(s) /AR Manager and the Program Director/Manager.
➢ Remain accessible to patients by phone or in person.
➢ Acts in the best interest of the program and the company; honors, supports, and protects the confidential proprietary data and rights of the company.
➢ May require support of multiple clinics within a general region and may include travel as needed
➢ Perform other tasks as assigned.
(Scope of the person's authority, including a list of jobs that report to this job).
(To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the competencies (minimum knowledge, skill, and ability) required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions).
Education/Licensure/Certification: High school diploma, GED, or equivalent education and experience.
ICD 10 certification or degree preferred
Required Knowledge: Microsoft Excel and Microsoft Outlook experience. Basic Mathematics skills required.
Experience Required: Office experience. Healthcare, medical office and/or collections experience is preferred.
Skill and Ability: Excellent interpersonal oral and written communication skills. Attention to detail and solid organizational skills. Proficiency in Microsoft Office skills. Ability to maintain highest level of confidentiality, discretion and integrity.
Physical Demands/Work Environment:
(The physical demands and work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.)
Finger Dexterity: Use primarily when operating calculator, telephone and keyboard.
Talking: To convey detailed or important instructions to employees, patients and applicants.
Hearing: Ability to hear normal conversations and receive ordinary information.
Vision: Average, ordinary, visual acuity necessary to prepare and
inspect documents. Clear vision at 20 inches or less and distant vision at 20 feet or more.
Physical Strength: Sedentary work; sitting much of the time. Exerts up to 10 pounds of force occasionally.
(The working conditions described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.)
➢ Ability to operate in an open work area with moderate everyday noise.
➢ Ability to perform other duties as required.
(The mental activities described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.)
Reasoning Ability: Ability to resolve practical problems. Ability to interpret a variety of instructions furnished in written, oral, diagram or schedule form. Ability to maintain confidentiality.
Mathematics Ability: Basic mathematics skills required.
Language Ability: Ability to read and interpret general business periodicals, professional journals, technical procedures, and governmental regulations.
Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public.
New Season is a leading provider of specialized quality care for opioid drug use management and recovery, operating since 1986 with more than 68 treatment centers in 20 states nationwide. We support the education and understanding of addiction as a disease, so that more patients and communities can find the care they need to focus on and overcome the current national opioid epidemic.
Addictive illness is a chronic brain disease that can be addressed with treatment and treatment works. Medication-Assisted Treatment (MAT) programs and the medications used today have been studied and proven to be highly successful in recovery over years of research.
At New Season, our programs use the latest science to create a comprehensive plan for patients that include MAT, counseling and medical services. Programs are customized to the patients' needs and services are delivered in a way that respects the dignity, value and self-worth of every individual. We are committed to each of our patients' success stories.
To learn more about how you can be a difference maker in your community, apply for immediate consideration.
Role: Clinic Authorization Specialist
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