Oaklawn Hospital

Job Summary: Provides accurate and timely insurance verification of eligibility and authorization. Audits clinical documentation to validate coding accuracy pre and post service.

Essential Functions:

• Consistently uses an outward mindset and puts forth exemplary effort in accomplishing his/her goals and objectives in a manner that helps others to achieve their goals and objectives.
• Provides accurate and timely insurance verification and authorization for ancillary, surgical, inpatient, and physician services.
• Follows appropriate point of service collection and notification processes.
• Demonstrates accuracy in gathering information and inputting data in all phases of insurance verification and the authorization process.
• Communicates with physicians, physician offices and hospital staff to obtain clarifying documentation for correct coding validation.

Minimum Qualifications: 18 years of age. CCA or equivalent certification. Relevant clinical or medical experience related to healthcare insurance verification, authorization and/or coding as determined by Oaklawn Administration.

Knowledge, Skills & Abilities: Knowledge of clinical and medical terminology, ICD-10 and CPT coding; computer skills. Strong verbal communication, interpersonal, organizational, customer service, and critical thinking skills. Ability to problem solve, handle conflict, and adapt to frequent change. Ability to interpret insurance records and related documentation. Ability to work independently, as well as to accept direction on given assignments.

Working Conditions: Work is generally performed within an office environment, with standard office equipment available.

Physical Requirements: Constantly sit, see/visual acuity, handle/grasp/feel, talk/hear. Occasionally lift/carry 1 to 25 lbs.