OSG Insurance Authorization Specialist Job in Ballwin, MO

at EyeCare Partners

EyeCare Partners is the nation’s leading provider of clinically integrated eye care. Our national network of over 300 ophthalmologists and 700 optometrists provides a lifetime of care to our patients with a mission to enhance vision, advance eye care and improve lives. Based in St. Louis, Missouri, over 650 ECP-affiliated practice locations provide care in 18 states and 80 markets, providing services that span the eye care continuum. For more information, visit www.eyecare-partners.com.

Our growing eye care organization has an immediate need for an Insurance Authorization Representative II who will handle all aspects of insurance authorizations for optical services and procedures.

*Remote optional after training is complete.*

Responsibilities

  • Maintain assignment rotation schedule for department
  • Monitor, track, and report department production
  • Audit individuals production
  • Create and maintain relationship with third party partners
  • Monitor daily workload for department, insure all appointments scheduled within 48 hours from the patient’s appointment are authorized and/or reviewed for eligibility.
  • Track use and success of automation features, monitor that the department utilizes automation features available.
  • Oversee office billing support calls and emails
  • Document and Communicate changes to senior leadership and other departments
  • Request, obtain, and document all prior authorizations (or denials of same) appropriately and in a timely manner
  • Obtain information about patient insurance coverage, benefits and eligibility
  • Maintain and update internal listing of insurance carriers that require authorization
  • Run system-generated reports to verify procedures by insurances requiring authorization are being captured
  • Assist collection team with obtaining retro authorizations
  • Coordinate with Call Center and Optical Offices on prior authorization and patient billing activity
  • Maintain the strictest confidentiality in accordance with HIPAA regulations and clinic requirements

Requirements: Education, Experience & Skills 
 

  • High school diploma or equivalent required
  • 2+ years' experience medical insurance billing/authorizations  
  • Work Experience as Team Lead or Supervisor
  • In-depth knowledge of performance metrics
  • Effective and efficient analyzing skills
  • Comprehensive understanding of insurance verification, contract benefits and medical terminology
  • Ability to enter data into various electronic systems while maintaining the integrity and accuracy of the data
  • Professional and calming tone of voice free of use of inappropriate grammar
  • Attentive listening skills
  • Ability to function effectively under stress of conflicting demands on time and attention, while successfully meeting deadlines
  • Ability to clearly articulate a response using appropriate voice modulation
  • Ability to communicate effectively with senior management and other departments
  • Strong Verbal and Written skills
  • Ability to maintain control of a call de-escalating issues and instilling confidence that a resolution will be found
  • Ability to perform essential job function with high degree of independence, flexibility, and creative problem solving techniques
  • Excellent organization, time management, and prioritization skills

 

Physical Requirements:

While performing the duties of this job, the employee is regularly required to talk and hear. The employee is occasionally required to stoop, kneel, crouch or crawl. The employee must frequently lift and/or move up to 10 pounds.

Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.

 

If you need assistance with this application, please contact (636) 227-2600

EyeCare Partners is an equal opportunity/affirmative action employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.

Please do not contact the office directly – only resumes submitted through this website will be considered.