Job Title: Insurance Verification and Authorization Specialist
Department: Revenue Cycle
Location: Grand Rapids, MI
FLSA Status: Non-Exempt (Hourly)
Manager Title: Director of Revenue Cycle
Position Summary: Performs day to day Insurance Verification and Prior Authorization activities to support the Revenue Cycle and to ensure reimbursement for services in a timely and accurate manner.
Duties and Responsibilities include the following. Other duties may be assigned.
- Verifies insurance coverage prior to visit
- Verifies insurance benefits, coverage of ordered services and provides patient cost estimate
- Works with insurance companies to obtain the necessary prior authorizations for services prior to patient visit
- Maintains current knowledge of payer policies and requirements
- Answers requests from patients, payers and other departments related to coverage of infusion services and prior authorizations
- Resource to team members and other departments related to insurance benefits and prior authorizations
- Actively participates in daily team huddles
- Maintains HIPAA compliance
- Other duties and projects as assigned
- 5 years related multi-site, multi- state Revenue Cycle experience and/or training; or equivalent combination of education and experience.
- High School Diploma or equivalent.
- Proficiency in Microsoft Office, including Outlook, Excel, Word, Teams and SharePoint.
- Ability to work efficiency and effectively under tight deadlines and high work volume
- Knowledge of infusion drugs a plus
- Experience with Allscripts PM a plus.
- Knowledge of medical billing and coding.
- Excellent problem-solving skills.
- Good analytical, accounting, and mathematical skills.
- Strong interpersonal and communication skills.
- Proficient typing skills.
- Strong attention to detail is essential in this role.
Physical Requirements/Working Conditions:
- Physical Requirement – Hearing (Frequently)
- Physical Requirement – Sitting (Frequently)
- Physical Requirement – Standing (Occasionally)
- Physical Requirement – Talking (Frequently)
- Physical Requirement – Walking (Occasionally)
- Physical Requirement – Near Vision (Constantly)
- Physical Requirement – Color Discrimination (Occasionally)
- Physical Requirement – Use of keyboard, mouse and/or computer equipment (Constantly)
- Occupational Exposure/Risk Potential – Inside office environment (Applicable)
At Infusion Associates, we are committed to a diverse and inclusive workplace and strongly encourage applicants from all backgrounds and walks of life to apply. Come join our collaborative and family-oriented team!
Infusion Associates grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, sexual orientation, veteran status, or any other legally protected category.
Infusion Associates complies with federal and state disability laws and makes reasonable accommodations for applicants and employees with disabilities. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact Melissa Johnson, HR Department, 616-954-0600.
- 401(k) matching
- Dental insurance
- Disability insurance
- Employee assistance program
- Health insurance
- Life insurance
- Paid time off
- Retirement plan
- Vision insurance
- 8-hour shift
- Day shift
- Monday to Friday
- High school or equivalent (Preferred)
Ability to Commute/Relocate:
- Grand Rapids, MI 49525: Reliably commute or planning to relocate before starting work (Required)
- Insurance verification: 2 years (Required)
- Medical Billing and Coding: 2 years (Required)
- Microsoft Office: 2 years (Preferred)
- Knowledge of Infusion Drugs: 2 years (Preferred)
- Allscripts PM: 2 years (Preferred)
- OncoEMR: 2 years (Preferred)