Insurance Representative

• Location: Remote, Must live within 50 Miles of Pensacola

• Facility: Sacred Heart Healthcare System

• Department: Patient Support Services

• Schedule: Day Shift | Full-Time

• Salary: $16.48 - $29.72 per hour

• Responsibilities: Confirms insurance coverage via payer portals and determines necessity for pre-authorization.
• Obtains authorization and processes referrals for services ordered by providers. Schedules appointments as appropriate and within required timeframes and assuring referrals are maintained within appropriate network and/or payer requirement.
• Remains current on referral policies and procedures, payer requirements, managed care matrix, portals and determines financial responsibility for services to be provided.
• Communicates with patients, healthcare providers, and third-party service providers regarding insurance coverage and barriers to care.
• Documents detailed information in the patient medical record and any actions taken regarding authorization status, coverage issues, restrictions and appointment details. Notifies patients and providers of services requested that are not authorized by insurance.

Licensure / Certification / Registration

• Required Credential(s):
• None Required.

Education

• High school diploma or equivalent required.

Work Experience

• 2+ years prior authorization experience required.

Additional Preferences:

• 1+ years of experience in a Medical Office working

• 1+ years of customer service experience