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Sysazzle

Authorization Rep

Sysazzle, Las Vegas, Nevada, us, 89105

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Pay range: $42/Hr. W2

Job title: Authorization Rep

Location: Las Vegas, NV, 89113

Duration: 7 Month contract

Summary

Job Summary : This position is responsible to obtain insurance eligibility and benefits information and obtain required authorizations. Reviews all insurance eligibility responses and communicates with the physician's office and insurance companies as needed regarding these responses or to obtain correct information. Works with Utilization Review staff to ensure authorizations cover services needed. May also estimate cost of service and patient's responsibility. Refers patients with questionable insurance coverage to the Eligibility Counselors. May assist in mentoring new hires Job Duties:

Obtains insurance eligibility and benefit information using various phone and on-line resources. Obtains appropriate authorizations and notifies insurance companies of patient arrival as needed. Works with Utilization Review staff and/or physicians' offices to assure eligibility and authorization requirements are completed within the required timeframe. Communicates with the appropriate nursing and/or billing staff when changes are made to the account that will affect the reimbursement. Makes appropriate corrections in the patient's record to ensure accuracy in order to prevent denials and/or problems with billing and reimbursement. Immediately refers "at risk" admission to eligibility, i.e., out of network, underinsured, max benefits, etc. Works with insurance eligibility responses and other appropriate reports and works with physicians and patients as needed to resolve issues and prevent billing delays. Maintains a satisfactory level of performance and adherence to workload standards. Estimates cost of service using ICD-9 or CPT codes. Performs calculations using insurance benefit information to accurately estimate patient responsibility. May lead and/or train new employees in account preparation and review functions Required Qualifications

Two years of customer service experience. Demonstrated good communications and computer skills. Physical Requirements: Interact with others requiring the employee to communicate information. Operate computers and other office equipment requiring the ability to move fingers and hands. See and read computer monitors and documents. Remain sitting or standing for long periods of time to perform work on a computer, telephone, or other equipment. Preferred Qualifications

Demonstrated knowledge of medical terminology. Experience in admitting, billing, collections, and/or insurance verification. Bi-Lingual Spanish speaking. Demonstrated knowledge of CPT/ICD-9 codes.

Required Educations:

HS Diploma or GED