Insurance Verification Clerk Job at Vitreous-Retina-Macula Consultants of New York PC, New York, NY

aW5hc0JkMFpZQ0ljU005QUFQdFVIL3pPRUE9PQ==
  • Vitreous-Retina-Macula Consultants of New York PC
  • New York, NY

Job Description

  • Creates and modifies authorizations and/or orders for new and existing Members in an accurate and timely matter
  • Insurance Verification determine if Participating in net work or out of Network- confirmed Members Benefits for services being rendered
  • Researches, troubleshoots, resolves authorization and/or order processing issues and discrepancies
  • Completes activities, including but not limited to, inbound/outbound calls, as assigned, faxes and emails
  • Obtains information from internal and external sources. Processes or triages the request via our medical management information system or external sources
  • Coordinates with Providers and Members regarding authorization requests and/or activities
  • Communicates with Care Management, Member Services, Membership and Eligibility and other internal departments regarding Member services, authorization requests and issues
  • Reviews all authorization requests for accuracy and prioritizing based on urgency
  • Documents communication, actions taken and barriers in the Medical Management System as it pertains to the Members Care or request for services
  • Utilizes internal and external systems to verify eligibility and Provider Information such as name, address, fax number, NPI and TAX ID.
  • Conducts follow-up, as necessary, to ensure member satisfaction and successful delivery of service
  • Protects the confidentiality of member information and adheres to company policies regarding confidentiality.
  • Performs other duties and special projects, as assigned


Experience Requirement: 

  • Entry Level  willing to train

Preferred Qualifications:

  • Knowledge of CPT and ICD9/ICD10 coding/ Clinical.
  • Understanding of insurance plans, i.e. HMO, POS, PPO
  • Knowledge of Excel and Word
  • Excellent Organizational Skills; Attention to Detail
  • Exceptional Communication Skills
  • Working Knowledge of Insurance Company Operations and Procedures
  • Excellent customer service skills
  • Ability to prioritize work in a fast-paced environment
  • Computer skills
  • Appeals/Retro active request skills
  • Sending Specialty Prescription when needed 
  • MRI Authorization Utilization Management 
  • Knowledge of Manufacture Co-Pay Assistance Program/Foundation. 

Benefits:

  • Health Insurance
  • Dental Insurance
  • Vision Insurance
  • Life Insurance
  • 401k
  • 401k  matching
  • Flexible Spending Account
  • Aflac
  • Optum Transit
  • Paid time off
  • Parental Leave

Job Tags

Full time, Flexible hours,

Similar Jobs

Berk Eye Care Center

Optician Job at Berk Eye Care Center

We are seeking an Optician to join our team! You will work alongside other medical professionals to provide exceptional care to our patients. BECC is a private, family owned optometry practice that has been in business for 70 years. We are seeking any individuals with... 

Seasoned Recruitment

Patient Care Assistant (Weekend Overnight Shift) Job at Seasoned Recruitment

 ...Job Description: Patient Care Assistant (Weekend Overnight Shift - 10:00 p.m. - 8:30 a.m. Saturdays and Sundays) Location: Escondido, CA Position Summary: The Overnight Patient Care Assistant works within their scope of practice under the guidance of a... 

CalOpps

Volunteer Opportunities (18396721) Job at CalOpps

 ...What makes San Mateo so great is the involvement and commitment of community members like you. So, why not join us by volunteering your time, energy and talents in continuing to make our city the best place to live! Visit www.cityofsanmateo.org/volunteer to view... 

Amazon.com Services LLC

Area Maintenance Manager - Whitestown, IN, RME Job at Amazon.com Services LLC

 ...DESCRIPTION Area Maintenance Manager Reliability, Maintenance, and Engineering (RME) is hiring for Area Maintenance Managers! At Amazon we believe that Every Day is still Day One! Were working to be the most customer-centric company on earth. To get there, we... 

Ginas Tech Jobs

Junior C++ Software Developer Job at Ginas Tech Jobs

 ...Junior C++ Software Developer, Chicago, IL Company Will Sponsor Visas! Company Will Relocate Junior C++ Software Developer Candidates! Responsibilities: The Junior C++ Software Developer will work collaboratively with the technology and business teams on our...