Referral/Ins Specialist - CU Sports Med

Responsible for ensuring the smooth operation of the insurance desk, including physical therapy, imaging, and provider procedures. Insurance referral duties include but are not limited to: verifying and adding ailments; obtaining, verifying and documenting insurance information; ensuring that appropriate insurance information is in the chart; working with payors to approve more patient visits; handling patient questions regarding insurance benefits and physician referrals; faxing/mailing patient information to payors; maintaining current knowledge on relevant changes taking place in the insurance industry; coordinating the information obtained with appropriate staff and departments to ensure maximum benefits for patients.

Providing back up to the Sports Admin team. JOB QUALIFICATIONS Education or Formal Training High school diploma or equivalent preferred Special Qualifications (Licensure, Registration, etc.) Knowledge, Skill and Ability Experience Previous experience in a medical setting preferred. Previous medical insurance experience preferred.

MATERIALS AND EQUIPMENT DIRECTLY USED Telephone Computer, Excel, Word, Epic, Insurance Portals Fax Machine Copy Machine WORKING ENVIRONMENT/PHYSICAL ACTIVITIES Requires eight hours of sitting and/or standing and walking. May require excessive standing (greater than 50%). Must be able to tolerate noise and multiple interruptions.

Manual dexterity to operate equipment and must be able to lift items from floor to 12 inches over head of varying weights of less than 20 pounds. Visual and hearing acuity for reading and using computer. INTERRELATIONSHIPS Interacts with patients, BCH staff, participating physicians and their staff members and insurance companies.

SUPERVISORY DUTIES None

AND RESPONSIBILITIES Consistent and on time attendance is an essential function of the position. Verify insurance information (physical therapy, imaging, and provider). Obtain authorizations/referrals (physical therapy, imaging, and provider procedures).

Track authorizations. Maintain appropriate insurance information in each chart. Provide insurance companies with appropriate information.

Handle client and staff questions regarding insurance. Maintain a current working knowledge of relevant changes taking place in the insurance industry. Complete disability forms for patients.

Scan documents into patient charts. Request release of records to patients, lawyers, other medical facilities, companies, workman’s comp, case manager. Sort faxes and distribute among the clinic.

Obtain any necessary signatures on plan of care documents. Complete Medicare Audits in conjunction with physical therapy department. Demonstrates knowledge of medical terminology and medical systems.

Maintains an understanding of the variables involved when working with different age groups. Additional duties may include assisting other departments, such as, front office, , as time permits. Employees are expected to comply with all regulatory requirements, including Joint Commission Standards.

Is familiar with organization, department and job specific Environment of Care areas, including Life Safety, Utilities Management, Hazardous Materials Communications, Emergency Preparedness, Infection Control and Medical Equipment Failure. Adheres to Standard Precautions as appropriate, which may include: the use of protective barriers, as appropriate (e.g., gloves, masks, gowns, pocket masks, and/or safety glasses); handling and disposing of infectious waste appropriately; and hand washing as appropriate.