• VERIFICATION & CODING SPECIALIST

    Job Locations US-TX-Dallas
    Job ID
    2018-1204
    Category
    Customer Service/Support
    Type
    Regular Full-Time
    Travel
    None
  • Company Overview

    Frontera Strategies, LP is a well-respected diagnostic healthcare provider of cardiac, pulmonary, vascular, and neurological studies in 6 states.  We are looking for a detailed oriented, individual to join our committed team of professionals.  Our staff strives to create an exceptional experience for each practice and patient – one focused on respectful relationships, teamwork, integrity and customer service.  This role will specialize in insurance verification and authorization for our in-office patient services.  Experience in a Surgical and Primary Care practice environment a plus.

    Position Overview

    Do you work in a dynamic entrepreneurial culture where employees THINK and ACT like owners towards creating profit? We have an operating system we call The Frontera Way. It’s how we operate and create a culture of accountability, purpose and profit. We need you if you’re a person that is confident and resourceful in getting things done, a sense of urgency and at the end of the day, you like to be precise and are fussy over details.

    Responsibilities

    Primary responsibilities include, but are not limited to:

    • Insures that the patient receives accurate, professional and compassionate communication.
    • Verifies the patient’s insurance eligibility and benefits, utilizing the carrier website for determining the medication formulary when necessary.
    • Obtains prior authorization from the patient’s insurance carrier.
    • Determines the patient’s cost and financial implications for in and out-of-network and communicates information to the patient and or the CSC Centralized Scheduling Coordinator).
    • Prepares required electronic and hard copy forms, documents necessary for prior authorization requests prior to sending to the carrier.
    • Provides information to the appropriate staff and provider to insure the delivery of high quality, cost-effective health care services.

    Qualifications

    • Minimum of 3 years of insurance verification experience, patient navigation, and/or patient field assistance.
    • Certification of CPT, ICD-9 and ICD-10 Codes.
    • Strong understanding of in-Network/Out-of-Network benefits investigating; deductibles, co-insurance, out of pocket expense & benefit exclusions.
    • Intermediate experience with MS Word, MS Excel, MS Outlook.

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