Answer inbound calls courteously and promptly. Fill out the claims documents correctly. Ask appropriate questions to find out what happened. Intake witness/customer/employee statements exactly as stated. Compose and mail out attorney letters.

Work on behalf of the patient to obtain or release authorizations. Help the patient obtain referrals. Obtain /understand patient insurance benefits and coverage. Help the patient obtain discounts for copays. Obtaining documentation from the provider in order to receive the authorization. Work with providers and payers to maximize reimbursement. Handle assigned cases in the expected time.

Collection of structured clinical data for prior authorization. Approve prior authorization requests. Independently responds to contacts ranging from routine to moderate complexity. Perform research to respond to inquiries and interpret policy provisions to determine most effective responses using established departmental procedures, HIPAA regulations, and corporate policies.

CompTia, Network + certification

High School Diploma