Job purpose
The Insurance Coordinator role consists of handling all authorizations for procedures and diagnostic studies,
verification of benefits prior to the scheduled appointment for all new patients, and new patient consults.
Duties and responsibilities
- Verify all new patients’ insurance benefits and verify patients out of network deductible.
- Responsible for informing all patients what their financial obligation will be for the office visit encounter.
- Responsible to document all authorizations, and benefit information in our EMR & Practice
Management systems.
- Responsible to review all Independent Medical Exams (IME) reports and to alert physicians, physician
assistants, and the staff if the patient has reached medical maximum improvement.
- Responsible for putting a pop up in our practice management system to alert staff should the patient reach
MMI. The IME determination also needs to be documented in our EMR system.
- Responsible to inform the staff if any patient’s benefits or authorizations are denied.
- Responds to written and telephone inquiries from patients regarding their insurance authorizations.
- Responsible for obtaining authorizations for all diagnostic studies request from our physicians.
- Responsible for scheduling procedures in all satellite locations which includes the hospitals and
ambulatory surgery centers.
- Responsible for preparing surgical packets and booking sheets for the provider and obtaining the
necessary medical clearances and or lab results for patients.
- Responsible for providing operative reports to surgical centers.
- Responsible for updating the physician procedure list.
- Responsible for alerting the staff of any changes in worker’s compensation guidelines.
- Responsible for updating and following up on cancelled procedures.
- Responsible for communicating efficiently with office personnel, administration, hospital representatives,
insurance company representatives, referring physician offices, physician assistants, Fedora (billing
company) and physicians.
- Maintains professionalism with patients, co-workers, and outside medical representatives.
- Maintains a file system necessary for proper organization of work.
- Maintains detailed knowledge of practice management and EMR and other computer software as it relates
to job functions
RequirementsSuccessful Candidates Will Possess these Qualifications
- High school diploma or general education degree (GED) equivalent. REQUIRED
- Minimum of three (3) years of medical insurance coordination/authorizations experience in a multi-provider
specialty practice, required. REQUIRED
- Ability to maintain complete confidentiality of information at all times.
- Excellent verbal and written communication skills.
- Ability to understand and demonstrate outstanding customer service skills while maintaining the highest level of
patient care at all times.
- Excellent organizational/multi-tasking skills with acute attention to details.
- Aptitude to apply common sense understanding to carry out instructions furnished in written, oral or diagram form
- Proficient with Microsoft Office Suite (Word, Excel, Power Point, Outlook).
- Ability to learn and use new software technologies for electronic patient medical records and practice