Surgery PreCert Coordinator (Remote after 6 months training at

POSITION SUMMARY: Assists patients with all aspects of insurance benefits for both office and hospital surgeries to promote patient confidence in their financial status and to make the surgical experience as smooth as possible.

Collects all pertinent information for upcoming surgeries including benefits, precertification requirements, prior approval necessity, deductible amounts, coinsurance, and copays.

This position will work from home upon successful completion of onboarding and training.

ESSENTIAL DUTIES AND RESPONSIBILITIES: * Obtains benefits and prior approval from patient's insurance carrier for all surgical cases.

* Documents benefits and prior approval including notes in PM Alert system.

* Acts as an effective liaison between the patient, surgeon, primary care physician, insurance company, hospital, and the patient surgery coordinator in disseminating insurance benefits.

* Knows when to address an issue with the physician or other administrative staff.

Employee must be reliable is assessing situations and forwarding to the physician team or other staff as appropriate.

* If needed, prepares and mails PreCert information so that the patient will receive it in a timely manner.

* Maintains accurate account of all surgical insurance verifications electronically.

Must have a working knowledge of patient management systems including insurance, information, and verification modules.

* Knowledge of the Retina processes within the precert dept to be able to obtain the most accurate authorization needed for the patient.

( buy and bill, specialty pharmacy, samples vs stock, Step Therapy, benefits investigations, and financial assistance). * Applies necessary communication in the PM and EHR alerts to the clinical teams.

* Maintains knowledge of Cornea Cross Linking procedure to accurately obtain prior authorization, pre-determination.

Communicates benefits and collection amounts with patient prior to the surgery being scheduled.

Completes HER telephone call log for accurate communication with the clinical teams.

* Maintains and obtains necessary VA authorizations for all HEC services provided to veteran patients.

* Obtains prior authorizations for necessary ordered radiology (MRI's, and CT Scans) for HEC providers.

* Ensures patient confidentiality and adheres to HIPAA requirements using all methods necessary including non-disclosure to unauthorized personnel, limiting record access and shredding discarded patient information.

* Performs all necessary job functions related to new technological implementations.

* Ensures all email and voice mail messages are handled on a daily basis.

If the issue can not be resolved on the same day, employee will notify parties involved about pending status.

* Provides supervisor with immediate notification of any changes in their workflow.

* Meets productivity goals set by supervisor.

Qualifications POSITION REQUIREMENTS: Minimum Qualifications: * High School Diploma or its equivalent * At least two years of experience in the field or in a related area * Experience using Microsoft Office programs, such as Excel and Word * Strong organizational, communication and inter-personal skills * Manage multiple projects/changing priorities Preferred Qualifications: 1.

Ophthalmology and insurance experience preferred