Magruder Eye Institute has been serving Orange, Osceola, and Seminole Counties for over 60 years, and is proud to be the leading ophthalmic group in the community. We offer a full spectrum of medical and surgical treatments so that all options are available to our patients. Magruder Eye Institute is committed to the delivery of personalized eye care of the highest quality. Not only do we value our patients, but we are also passionate about our staff. Our amazing leadership team is committed to cultivating and maintaining an employee centric work environment where every employee has a voice and a platform to share their ideas and suggestions, are encouraged and incentivized to broaden their education and training and are invited to participate in the numerous employee activities offered monthly.

Magruder Eye Institute is affiliated with Ascend Vision Partners premier network of Ophthalmic Medical Services.

Summary

Reporting to the Senior Billing Manager, the Verification and Authorization Specialist will have prior medical insurance authorization and verification experience for surgical procedures.

Essential Duties & Responsibilities:

• Maintains patient demographic information and data collection systems.
• Verifies insurance eligibility for both medical and vision insurances for upcoming appointments by utilizing online websites or by contacting the carriers directly.
• Obtains referrals from the PCP or authorizations from the insurance prior to the upcoming appointment.
• Consistently communicate with the patient on the status of the referral or authorization prior to the appointment.
• Reviews patient deductibles and/or copays and document in notes sections as well as the pop-ups in the billing system.
• Assists front desk staff and call center staff in understanding verification of eligibility or status of the referral and/or the authorization.
• Verifies accuracy of referral / authorization and enter in to Managed Visits.
• Participates in development of organization procedures and update of forms and manuals.
• Answers questions from patients, clerical staff, and insurance companies.
• Works in conjunction with the front desk staff and surgical schedulers to ensure clean billing.
• Manage and utilize time effectively, assist others within the department, to ensure department meets required service levels.

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Required Education and Experience:

• High School Diploma or GED equivalent
• Minimum of 1-year relevant experience in insurance verification and authorization in a medical office and/or training, or equivalent combination of education and experience.

Core Competencies:

• Proficient in computers and relevant software applications and practice management technology.
• Possession of strong problem-solving skills and sound judgement.
• Ability to collaborate across departments and build effective relationships with internal and external customers to achieve goals.
• Knowledge of customer service principles and practices.
• Ability to achieve team goals while demonstrating organizational values and utilizing resources responsibly.
• Ability to be proactive and take initiative.
• Exhibit high level of quality through attention to detail and monitoring work.
• Possession of strong organizational skills.
• Excellent verbal and written communication, as well as exceptional interpersonal communication skills.
• Ability to work independently on assigned tasks, as well as to accept direction on given assignments.
• Deals with confidential information and/or issues using discretion and judgement.

Preferred Experience:

• Prior insurance verification and authorization experience for ophthalmic surgical procedures.

Work Environment & Physical Demands:

• Work is performed in an office setting.
• Physical demands of position: sitting, standing, walking, typing, phone communication, face to face conversation.

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