MEDICAL ELIGIBILITY/AUTHORIZATION REPRESENTATIVE
Sacramento, CA 95819
- Contacting patient or referring physicians to obtain any missing information.
- Following up on any missing information for patient appointments.
- Following up on ' one-week out' appointments and requesting any missing information.
- Obtaining eligibility for new and existing patients.
- Inputting new and updated insurance information in the system, accurately.
- Acquiring any needed authorization from insurance companies.
- Alerting accounts for out of pocket amounts to collect.
- Verifying benefits for appointments and marking appropriate forms for co-payments or co-insurance to be paid by patient.
- Ensuring payments, according to Medicare or Payer contracts.
- Working any assigned tasks per policy guidelines.
- Interacting with patients in person or via telephone regarding billing questions.
- Requesting adjustments per policy guidelines, when needed on an account.
- Preparing payment agreements and refund requests, per policy guidelines.
- Completing 1st and 2nd level appeals on denied, unpaid or underpaid claims.
- Attaching chart notes or referrals, if needed by claim.
- Detail-oriented and excellent organization skills.
- Proficient in MS Office Suite.
- Attention to detail and ability to multi-task.
NextGen software preferred
Bilingual Spanish, is preferred
- High School Diploma or GED
- Medical billing and/or Eligibility experience
- MS Office Proficient
Must be able to provide a minimum of two super visory references, clear a thorough drug screening, criminal background check and have the ability to provide proper identification to verify eligibility to work in the USA. Other compliance factors may be involved, depending on position. River City Staffing is an Equal Opportunity Employer.