Insurance

• Verify patient insurance eligibility, active coverage, benefits, effective dates, plan type, network status, copays, deductibles, coinsurance, out-of-pocket information, referral requirements, and authorization requirements
• Document eligibility and benefit information in EZ Derm or the designated workflow
• Communicate with insurance companies about eligibility, benefits, authorization requirements, and pending requests
• Document insurance calls, including representative name, reference number, date and time, phone number, information obtained, and next action
• Manage prior authorizations from submission through final resolution
• Submit prior authorization requests with complete supporting documentation
• Track status updates, additional information requests, approvals, denials, authorization numbers, approved codes, units, and date ranges
• Manage prior authorizations for biologic medications
• Create and maintain follow-up tasks for unresolved insurance and authorization items
• Track pending items through completion, resolution, or escalation
• Escalate clinical, financial, missing information, denial, delay, or decision-making concerns as appropriate
• Handle insurance-related phone calls as the primary focus
• Provide overflow patient call support as operational needs allow
• Provide a daily End of Day report summarizing completed work and outstanding items
• Maintain patient confidentiality and comply with HIPAA and practice policies
• Use EZ Derm, 3CX, insurance portals, payer systems, task workflows, phone, email, and internal communication systems

Insurance jobs in Argentina

Bilingual Prior Authorization, Insurance Verification Specialist