- Reviews complex insurance eligibility and authorization requirements for patient services.
- Resolves escalated insurance or scheduling issues impacting patient access.
- Serves as a subject matter expert for clinic staff on insurance policies and procedures.
- Assists with training new employees and providing guidance to team members.
- Monitors authorization and referral workflows to ensure timely processing.
- Supports clinic leadership with workflow improvements and operational efficiencies.
- Ensures accurate documentation of insurance information within patient records.
- Assists with coordination of high-priority patient appointments and services.
- Collaborates with providers, clinical staff, and insurance representatives to resolve coverage issues.
- Performs other duties as assigned.
- Advanced knowledge of insurance verification, authorization processes, and clinic workflows.
- Ability to interpret insurance requirements and resolve complex coverage issues.
- Demonstrates strong analytical and problem-solving skills.
- Ability to train and mentor staff.
- Skilled in coordinating multiple priorities in a high-volume clinic environment.
- Proficient with electronic medical records, scheduling systems, and Microsoft Office applications.
- Strong interpersonal communication and conflict-resolution skills.
Education:
High School diploma or GED equivalent required.
Experience:
Four (4) years of directly related experience is required.