Responsible for processing insurance claims in a timely and accurate manner entailing gathering and verifying claim information, researching and resolving claim issues, and communicating with claimants to ensure their satisfaction. The role involves ensuring the timely and accurate adjudication and payment of medical claims, maintaining accurate notes, processing appeals, serving as an in-house expert, identifying operational issues, and contributing to team goals.
Serves as front line support for the Patient Connection Center within Piedmont Healthcare. Reviews orders for complex outpatient services and specialized procedures (i.e., surgeries) to ensure completeness prior to scheduling. Prepares for the patient visit by verifying patient insurance, confirming benefits, determining authorization requirements, reviewing medical necessity, and creating patient liability estimates.
As a Payer Relations Coordinator, you're responsible for managing relationships with insurance payers to ensure accurate and timely reimbursement for skilled nursing services. This role involves verifying patient insurance benefits, obtaining prior authorizations, and resolving any issues related to insurance coverage. The coordinator will work closely with the admissions, billing, and clinical teams to ensure compliance with insurance requirements optimize revenue cycle outcomes.