Outpatient Infusion Preservice Insurance Specialist Full Time
$47,840–$63,461 year
On-site · Fresno, California, United States
Job Summary
This role supports the Revenue Cycle by preventing payer-denial issues through compliance with precertification and authorization requirements, interpreting insurance benefits, evaluating patient liabilities and payer guidelines for various payers, and performing financial clearance and preregistration tasks, including reviewing patient information and verifying treatment authorization while coordinating with insurance companies, physician offices, and Shared Service Center to ensure accurate and complete information.
Required Qualifications
- High school diploma or equivalent required
- Extensive knowledge of medical terminology required
- Knowledge of DRG, CPT, APC and ICD-9-CM codes and their application to patient registration and precertification
- Comprehensive knowledge of Medicare, Medi-Cal, Commercial Insurance, Worker Compensation benefits
- Knowledge of clinical procedures and acuity as it applies to population by gender and age
- Intermediate to advanced skills with Microsoft Office, scheduling applications, and ADT systems
- Effective oral and written communication skills, teamwork, bias for action, adaptability, initiative
- NAHAM certification preferred
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