Responsible for reviewing requests for services that require pre-certification and or referrals.
TYPICAL PHYSICAL DEMANDS: Requires sitting for long periods of time; also stooping, bending and stretching for files and supplies. Occasionally lifting files or paper weighing up to 50 pounds. Requires manual dexterity sufficient to operate a keyboard, operate a calculator, telephone, copier and such other office equipment as necessary. Vision must be correctable to 20/20 and hearing must be in the normal range for telephone contacts. It is necessary to view and type on computer screens for long periods and to work in an environment which can be very stressful.
TYPICAL WORKING CONDITIONS: Work is performed in an office environment. Involves frequent contact with staff. Work may be stressful at times.
Education: High School graduate of GED required.
Experience: Three years of insurance and/or billing experience including one year of experience in a health care organization.
Knowledge of accounts receivable practices and medical patient accounting services procedures. Knowledge of coding and clinic operating policies and procedures. Knowledge of insurance agency reimbursement procedures and practices. Knowledge of the organization’s policies and procedures. Skill in using computer and calculator. Ability to examine documents for accuracy and completeness. Ability to prepare records in accordance with detailed instructions. Ability to work effectively with co-workers and supervisors as a team member. Ability to communicate clearly. Upholds effective work habits including, but not limited to, regular attendance, teamwork, initiative, dependability and promptness.