Insurance/Authorization Review

Newton-Wellesley Hospital(NWH)
Full time Full day
Newton, MA

Insurance/Authorization Review


- (3172319)



JOB SUMMARY:


Insurance Authorization/Reviewer is responsible for all insurance verification, documentation, obtaining referrals and authorization, notification of benefit and authorization per each insurance provider guidelines



ESSENTIAL FUNCTIONS




o Develops and maintains up to date knowledge of individual insurance program


requirements relative to multispecialty clinic medical services and


Department of Rehabilitation Services.




o Develops strong working relationship with third party payor offices and


physician offices.




o Explains and reviews all insurance requirements with patients to assist them


in understanding the impact of their individual policies on receiving Rehab


services at NWH and are able to successfully obtain all appropriate


paperwork necessary.




o Assists patient in obtaining appropriate paperwork as necessary.




o Obtains and maintains third party payor approval, tracks authorizations and


visits to insure compliance with all third party payor requirements.




SECONDARY RESPONSIBILITIES




o Answers the telephone; takes, screens and relays messages and/or provides


routine information pertinent to operation of Multi-specialty Clinic and


Department of Rehabilitation Services.




o Schedules initial and follow-up appointments for all patients seen in


Department of Rehabilitation Services.



o Transcribes, types, does word processing, data entry, proofreads, corrects,


types and distributes correspondence, reports, patient records and other


materials as necessary for efficient operations.




o Organizes and maintains files, records, logs and other controlling systems;


retrieves files as needed; Communicates needs to health information


services regarding medical records needs for multispecialty clinic and


coordinates activity to assure records available when necessary.




o Sorts, distributes and/or files incoming documents and other


correspondence.




o Reserves rooms and audio visual equipment, as needed.




o Photocopies and releases patient records to third party payors, physicians


and other requesting personnel.




o Greets patients and their families; prepares and assists with all


documentation necessary for completion of chart, insurance


authorization, outcomes analysis and third party payor requirements


for medical specialty clinic and Department of Rehabilitation


Services.




o Prepares documents for treatment and equipment charges to be billed. Does


data entry of charges.




o Reviews copayment information, collects copayments, issues receipts and


maintains appropriate accounting information.




o Performs other duties as assigned.




Primary Location
MA-Newton-NWH 372 Washington
Work Locations
NWH 372 Washington 372 Washington Street Newton 02458
Job
Admin/Clerical/CustService-Other
Organization
Newton-Wellesley Hospital(NWH)
Schedule
Full-time
Standard Hours
40
Shift
Day Job
Employee Status
Regular
Recruiting Department
NWH Pain Service
Job Posting
Oct 20, 2021

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