Jr Insurance Authorization Agent

hace 1 semana

San Francisco, Heredia, Costa Rica Auxis A tiempo completo


Job Summary

The Jr Insurance Authorization Agent will be working for a fast-growing business process outsourcing provider to provide support to one of our largest accounts and leading provider of healthcare services. This provider serves 959 hospitals and 2979 physician practices with over 50 million patient encounters annually.

In your role, you will be supporting patient inquiries, directly affecting the patient experience and improving the health of communities.



Responsibilities

Duties will be performed by each individual depending on the assignment of responsibilities:

  • Perform pre-registration and insurance verification within 3-5 days prior to the date of service for both inpatient and outpatient services. For notification received with less than 3 days advanced notice perform within 24 hours of notification.
  • Follow scripted benefits verification and pre-certification format in Meditech custom benefits screen and record benefits and pre-certification information in the approved standard format
  • Assign Insurance Plans (IPlan's) accurately
  • Perform electronic insurance eligibility confirmation when applicable and document results
  • Complete Medicare Secondary Payor Questionnaire as applicable for retention in the managing system (i.e. OnBase)
  • Calculate patient cost share and be prepared to collect via phone or make payment arrangement
  • Contact the patient via phone (with as much advance notice as possible, preferably 48 hours prior to the date of service)to confirm or obtain missing demographic information, quote/collect patient cost share, and instruct the patient on where to present at the time of appointment
  • Receive and record payments from patients for services scheduled.
  • Utilize an appropriate communication system to facilitate communication with the hospital gatekeeper
  • Ensure appropriate documentation is entered in standard format on the patient record. This should be performed in the applicable Health Information System (i.e. Meditech) and if necessary any other subsidiary systems if they are not automatically updated.
  • Contact the physician to resolve issues regarding prior authorization or referral forms
  • Research Patient Visit History to ensure compliance with payer-specific payment window rules
  • Perform insurance verification and pre-certification follow-up for the prior day's walk-in admissions/registrations and account status changes by an assigned facility as per SSC guidelines.
  • Communicates with hospital-based Case Manager as necessary to ensure prompt resolution of pre-existing, non-covered, and re-certification issues
  • Meets/exceeds performance expectations and completes work within the required time frames
  • Implements and follows system downtime procedures when necessary
  • Practice and adhere to the "Code of Conduct" philosophy and "Mission and Value Statement"
  • Other duties as assigned.


Skills and Experience

  • English – Spanish Language (Oral and writing B2+ or above).
  • Must have a high school diploma.
  • At least 6 months of experience in Customer Service positions.
  • This job adjusts to the Eastern Time Zone and follows a US holiday schedule.
  • Strong customer service skills
  • Excellent communication skills
  • Comfortable working in a high volume/high demand environment
  • Good presentation and a polite, tactful and friendly character.

#LI-MM2



About Auxis

Auxis places a high priority on employee growth and development, fostering an environment where you can advance in your career. Our culture empowers you to perform at your best, aligning with our team's shared goals. We are continuously working to enhance our culture and environment, investing in tools to gain better insights into the heartbeat of our organization.

Benefits:

  • Comprehensive health benefits covering medical, vision, and dental.
  • Transportation subsidy.
  • Solidarity Association.
  • Training and development programs.
  • Employee recognition program.
  • Generous paid time off and family leave.
  • Enjoy a paid day off on your birthday

  • Jr Insurance Authorization Agent

    hace 2 semanas

    San Francisco, Heredia, Costa Rica Auxis A tiempo completo

    Job SummaryThe Jr Insurance Authorization Agent will be working for a fast-growing business process outsourcing provider to provide support to one of our largest accounts and leading provider of healthcare services. This provider serves 959 hospitals and 2979 physician practices with over 50 million patient encounters annually.In your role, you will be...

  • Senior/Lead Developer .Net Core

    hace 2 semanas

    San Francisco, Heredia, Costa Rica UST A tiempo completo

    Role DescriptionSenior/Lead Developer .Net Core / .Net FrameworkDeveloper I - Software EngineeringWho We AreBorn digital, UST transforms lives through the power of technology. We walk alongside our clients and partners, embedding innovation and agility into everything they do. We help them create transformative experiences and human-centered solutions for a...

  • Welcome Call Specialist

    hace 2 días

    San Francisco, Heredia, Costa Rica Solventum A tiempo completo

    Gracias por tu interés en unirte a Solventum. Solventum es una empresa nueva en el ámbito de salud, pero con una sólida experiencia en la resolución de desafíos que transforman vidas y fortalecen el trabajo de los profesionales de la salud. En Solventum, las personas son el centro de cada innovación que desarrollamos. Con empatía, conocimiento y...

  • Welcome Call Specialist

    hace 2 días

    San Francisco, Heredia, Costa Rica SOLVENTUM A tiempo completo

    Gracias por tu interés en unirte a Solventum. Solventum es una empresa nueva en el ámbito de salud, pero con una sólida experiencia en la resolución de desafíos que transforman vidas y fortalecen el trabajo de los profesionales de la salud. En Solventum, las personas son el centro de cada innovación que desarrollamos. Con empatía, conocimiento y...

  • Insurance Authorization Coordinator

    hace 6 días

    San José, Costa Rica Dr. Dental A tiempo completo

    **REMOTE POSITION!! We offer competitive salary, full benefits package, Paid Time Off, and opportunities for professional growth. **MUST RESIDE IN Costa Rica** Dr. Dental is a growing leader in addiction treatment services. We provide care across the nation touching the lives of more than 30,000 patients daily. As an **Insurance Coordinator**, you play a...

  • Senior Corporate Travel Agent

    hace 3 días

    San José, Costa Rica BairesDev A tiempo completo

    Who We are BairesDev is proud to be the fastest-growing company in America. With people in five continents and world-class clients, we are only as strong as the multicultural teams at the heart of our business. To consistently deliver the highest quality solutions to our clients, we only hire the Top 1% of the best talents and nurture their professional...

  • Agente Full Bilingue

    hace 2 semanas

    San José, Costa Rica BMNS A tiempo completo

    Job Overview: We are seeking a highly organized and detail-oriented individual to join our team as a Remote Gate Clerk. As the primary point of contact for drivers and personnel, you will play a crucial role in ensuring the smooth flow of vehicles while maintaining compliance with security and safety protocols. Your responsibilities will include customer...

  • Collection Agent

    hace 4 días

    San José, Costa Rica Monifai A tiempo completo

    Overview: **Empowering people with fast and effective lending solutions.** Monifai is a modern fintech solution that offers a simplified, 100% digital way to access money without experiencing slow, manual processes. Come join our global team and grow your career now. **Responsibilities**: - Manage all customer communications and services relating to...

  • Mid Full Stack Developer

    hace 4 días

    San José, Costa Rica Equifax A tiempo completo

    Equifax is where you can power your possible. If you want to achieve your true potential, chart new paths, develop new skills, collaborate with bright minds, and make a meaningful impact, we want to hear from you. **Full Stack Developer **will develop strategic design and requirements on small systems or modules of large systems (large scale). **What...

  • Customer Support Agent

    hace 1 semana

    San José, Costa Rica iGP Operations LTD A tiempo completo

    **About Us: We at iGaming Platform are all about **positive attitude**! We have a high-energy atmosphere, and we love to encourage one another. We don't avoid challenges; rather, we embrace them as opportunities to **grow and learn**. We want people to take the action and **lead by example**. In everything we do, we constantly aim for excellence by going...

  • Lead Associate

    hace 6 días

    San José, Costa Rica WNS Global Services A tiempo completo

    **Company Description** WNS (Holdings) Limited (NYSE: WNS) is a global Business Process Management (BPM) leader. WNS offers business value to 400+global clients by combining operational excellence with deep domain expertise in key industry verticals, including Banking and Financial Services, Consulting and Professional Services, Healthcare, Insurance,...

  • Service Desk Support Agent

    hace 6 días

    San José, Costa Rica Equifax A tiempo completo

    Equifax is where you can power your possible. If you want to achieve your true potential, chart new paths, develop new skills, collaborate with bright minds, and make a meaningful impact, we want to hear from you. **What you’ll do** - Provide support for internal Equifax employees and contractors for system-related issues impacting multiple users and...

  • Senior. Associate

    hace 6 días

    San José, Costa Rica WNS Global Services A tiempo completo

    **Company Description** WNS (Holdings) Limited (NYSE: WNS) is a global Business Process Management (BPM) leader. WNS offers business value to 400+global clients by combining operational excellence with deep domain expertise in key industry verticals, including Banking and Financial Services, Consulting and Professional Services, Healthcare, Insurance,...

  • Solution Support Specialist

    hace 3 días

    San José, Costa Rica TD SYNNEX A tiempo completo

    **About The Role** Performs order entry and is the primary customer and supplier interface for all customer issues related to order management for products within a major business group. Initiates and/or maintains effective communications with internal and external customers regarding product status, as appropriate. **What You'll Do** - Facilitates the...