Job Information
TEKsystems Patient Authorization & Referral Representative in Spokane, Washington
Description
• Verifies insurance benefits and eligibility on all new referrals. • Performs monthly verification of DSHS coverage for long term Medicaid patients and weekly verification for capitated Hospice patients. • Assist in evaluation of documentation to determine if patient meets criteria for coverage of therapy. • Gather necessary information to assure accuracy and completeness of forms and reports; Work with management and staff to correct omissions, errors, office systems problems, etc. • Responsible for creating Cost Disclosure/Advance beneficiary notices for Medicare patients and tracking for signed form. • Responsible for generating benefits letter to inform patient/responsible party of financial responsibility and sending to patient. • Responsible for entering new patient and physician date into the software database, including new therapy sessions on existing patients; Enter ICD-9/ICD-10 codes as needed. • Obtain PCP referral request and follow-up. • Document appropriately in patient electronic record regarding payer/billing information. • Obtain initial pre-authorizations as required by insurance plans. • Verification of physician licensure on an ongoing basis. • Support and incorporate Sisters of Providence Health System Mission into daily activities. • Participate in QA/QI. • Responsible for performing Medicare Part D eligibility and drug formulary checks. • Prepare hospital charity agreements and send and track patient financial assistance applications.
Skills
medical terminology, customer service, insurance verification, Emr, Epic, Medical record, epic inpatient, infusion
Top Skills Details
medical terminology,customer service,insurance verification
Additional Skills & Qualifications
• One year+ reimbursement experience • One year+ verification/insurance benefits • Ability to type quickly and accurately. • Ability to communicate effectively both written and orally. • General computer knowledge and skills, including word processing, spreadsheets and database software. • Knowledge of office equipment. • Knowledge of medical terminology. • Customer service skills. • Knowledge of medical reimbursement. • High school diploma/GED
Experience Level
Expert Level
Pay and Benefits
The pay range for this position is $22.00 - $25.00
Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: • Medical, dental & vision • Critical Illness, Accident, and Hospital • 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available • Life Insurance (Voluntary Life & AD&D for the employee and dependents) • Short and long-term disability • Health Spending Account (HSA) • Transportation benefits • Employee Assistance Program • Time Off/Leave (PTO, Vacation or Sick Leave)
Workplace Type
This is a fully onsite position in Spokane,WA.
Application Deadline
This position will be accepting applications until Dec 26, 2024.
About TEKsystems:
We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
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