Complete all aspects of the insurance pre-authorization process to ensure timely approval for scheduled services, including verifying coverage, applying appropriate coding, and communicating with insurance carriers.
Monitor and manage patient accounts,work queues,and insurance documentation to support accurate billing and minimize denials or delays in care.
Identify when prior authorizations, waivers, or patient notifications are required; prepare documentation and collaborate with front desk and clinical teams to ensure proper follow- through.
Respond to patient inquiries related to billing and insurance denials, providing clear explanations and resolving issues or referring to appropriate financial resources as needed.
Resolve authorization-related claim rejections and initiate retro-authorization requests when appropriate to support revenue recovery.
Act as a resource to providers and staff by answering coverage-related questions and coordinating with insurance carriers on complex or specialty-specific services.
Maintain accurate and thorough documentation of all actions, contacts, and outcomes in accordance with standardized workflows.
Collaborate with clinical and administrative teams to ensure proper documentation and compliance with billing and reimbursement guidelines.
Support process improvements, participate in departmental meetings, and contribute to team goals related to efficiency, quality, and patient satisfaction.
Assist with onboarding and training of new staff by providing guidance and sharing expertise as needed.