Boston, MA 02101
Our client is seeking a pre-registration coordinator to verify eligibility of insurance and process incoming referrals received by phone, fax, internet and mail. Input referral information into scheduling system and link to appointments as appropriate. This is a contract assignment starting ASAP for 6 weeks, possibly longer.
• Verifies eligibility of insurance for all patients with pending appointment and records verification in scheduling system.
• Identify managed care appointments needing referrals for all services and program
• Investigate and obtain referrals via electronic tools (STARS, WEB MD, POS etc)
• Identifies patients who were seen without referral and contacts PCP offices in an attempt to obtain retroactive referrals
• Enter referral information into scheduling system.
• Maintain paper file system for referrals
• Maintain and update POS provider information as needed.
• Maintains a thorough knowledge of third party requirements via insurance manuals, newsletters, and seminars.
• Acts as a patient advocate by facilitating proper processing of referrals. Assists patient in issue resolution around managed care insurance claims and billing problems
• Works with the Manager of Patient Accounts to support and facilitate periodic educational forums for administrative staff.
• Performs other duties as assigned by the Manager
• Third Party Billing Certificate or Associates Degree in Accounting required.
• Minimum of two years in medical office setting, including experience in both front and back office functions.
• Applicant must demonstrated superior knowledge of HMO and PPO requirements