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Hanger, Inc. · 3 weeks ago

Benefits & Authorization Specialist III

United States

Full-time

Hybrid

Senior Level

$18/hr - $25/hr

6+ years exp

Hanger, Inc. is the world's premier provider of orthotic and prosthetic services and products, and they are seeking a Benefits & Authorization Specialist III. The core focus of this role is to review patient information for insurance coverage, verify eligibility with health insurance companies, and maintain accurate documentation for patient authorizations.

Health CareHospitalMedical Device

Responsibilities

Promote the values of Hanger

Reviews documentation to ensure it meets the needs of the payer and is in alignment with payer medical policy

Communicates with clinic and or consolidated staff to obtain necessary documentation

Communicates with insurance companies to verify patient benefits and authorization requirements

Submit authorization request to insurance companies and follows up as needed

Ensures authorizations provided by insurance companies are accurate and contain correct codes, quantities, and appropriate authorization date ranges

Updates patient chart with necessary notations and documentation

Contact patient for updated insurance information

In the event of a denial of authorization communicate with clinic to determine if the submission of an appeal if appropriate. If appropriate submit the appeal to the payer and follow up as needed

Perform other duties as assigned

Qualification

Insurance verification experienceHIPAAICD-9ICD-10 codingCustomer service skillsProficient in MS OfficeBasic math skillsCommunication skillsInterpersonal skillsDetail-orientedTeam player

Required

High school diploma or equivalent

Minimum of 6 years of insurance verification and/or benefits experience

Must have, or be eligible to obtain, a valid driver's license and driving record within the standards outlined within Hanger's Motor Vehicle Safety Policy and Procedures

Preferred

Able to initiate communication with clinic staff and insurance companies

Excellent customer service and communication skills

Able to manage multiple responsibilities and to prioritize duties/tasks in a fast-paced working environment

Good interpersonal, oral and written communication skills, including the ability to follow written and verbal directions

Resourceful and flexible team player who excels at building trusting relationships with patients, referral sources and colleagues

Working knowledge of HIPAA and other medical insurance regulations and terminology for private payer, state and federal plans including coding, billing and reimbursement protocols

Working knowledge of ICD-9, ICD-10, HCPC/CPT and other coding

Proficient computer software, such as MS Word, Excel, and automated billing systems

Able to use various type of office equipment, such as, facsimile machines, calculator, postage machine, copiers, etc

Knowledge of state, federal and regional collection, and reimbursement laws

Must have an enthusiastic and positive attitude

Ability to work independently, exercise creativity, and be attentive to detail

Proficiency with basic math and accounting skills

Act with integrity in all ways and at all times, remaining honest, transparent, and respectful in all relationships

Keep the patient at the center of everything that you do, building lifelong trust

Foster open collaboration and constructive dialogue with everyone around you

Continuously innovate new solutions, influencing and responding to change

Focus on superior outcomes, and calibrate work processes for outstanding results