Insurance Authorization Representative

POSITION SUMMARY:

Assists Insurance Processor II’s and Supervisor with completion of verifications and prior authorizations of DME coverage, evaluates portion to be paid by customer, and performs other Insurance related assignments as directed.

ESSENTIAL FUNCTIONS:

• Handles activities related to verification of insurance benefits for customers.

• Notifies customer of any deductible and/or coinsurance due.

• Completes financial assistance applications, if appropriate.

• Contacts customer directly when necessary to obtain additional information.

• Contacts Primary Care Physicians with regard to referral information.

• Complies pre-certification information and forwards to insurance company to establish medical necessity and prior approval.

• Performs regular follow-up calls with insurance companies checking status of prior authorization request.  Submits additional documentation, if required.

• Reviews denials and follows up according to standard procedures.  Researches other payment options with customer, when appropriate.

• Answers phones for Insurance Skill.

• Promote and maintain teamwork with internal and external Hoveround associates and Health Plans.

• Participates in training sessions as requested.

• Maintains confidentiality of all records.

• Works minimum 40-hour work week with required overtime as business needs dictate.