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WVU Medicine, the West Virginia University Health System, provides advanced healthcare services to the people of West Virginia and surrounding regions. Encompas
Insurance Specialist III
Location
United States
Posted
141 days ago
Salary
0
Seniority
Mid Level
Job Description
Insurance Specialist III
West Virginia University
• Responsible for obtaining authorizations for elective infusions and injections to financially clear patients and ensure reimbursement for the organization. • Escalates financial clearance risks as appropriate in compliance with the Financial Clearance Program. • Serving as a liaison between clinical teams and pharmacists ensuring effective communication regarding infusion prior authorization issues. • Cases are to be coded, and clinical documentation reviewed to ensure the documentation is complete to maximize reimbursement.
Job Requirements
- High school graduate or equivalent with 2 years working experience in a medical environment, OR Associate’s degree and 1 year of experience in a medical environment.
- 3 years’ experience of knowledge and interpretation of medical terminology, ICD-10, and CPT codes.
- Understanding of authorization processes, insurance guidelines, and third-party payors practices.
- Proficiency in Microsoft Office applications.
- Excellent communication and interpersonal skills.
- Ability to prioritize to meet deadlines and multitask a large work volume with a high level of efficiency and attention to detail.
- Basic computer skills.
Benefits
- Health insurance
- 401(k) retirement plans
- Paid time off
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