<ul> <li>Responds to incoming calls regarding insurance authorizations, information requests, and denials. </li><li>Regularly updates knowledge of third party payor regulations, and updates staff in writing of any changes as they become known. </li><li>Verifies insurance pre-authorization/certification for services, including number of visits approved and dates that services are covered. </li><li>Accurately completes insurance tracking sheet for each patient and each discipline. </li><li>Tracks insurance caps and ensures that patient treatment does not exceed monetary allowance as outlined by insurance company; notifies patient and therapist of insurance caps. </li><li>Acts as liaison between patients and clinicians regarding authorization and usage of visits. </li><li>Follows through on requests for information within 24 hours </li><li>Recognizes referral errors and makes corrections as needed. </li><li>Compiles and submits appeal letters on receipt of denial. </li><li>Obtains and submits information to resolve denials. </li><li>Consistently ensures documentation received for extension approvals are in the medical record on the date received and communicated to the patient to ensure no interruption in care. </li><li>Provide accurate and comprehensive information about all third party payors and requirements for authorized visits. </li><li>Performs the basic duties of the Rehab Department secretary to cover brief absences. </li><li>Communicate clearly and tactfully with patients and their families, maintaining confidentiality at all times. </li><li>Attends departmental meetings as required. </li><li>Acts as a resource and support person for front office staff. </li><li>Perform other work related duties as assigned or requested. </li></ul> <p>Consistently provides service excellence to all patients, family members, visitors, volunteers and co-workers in a manner that reflects Cape Cod Hospital's commitment to CARES: compassion, accountability, respect, excellence and service.</p> <ul> <li>Ability to read, write and communicate in English. </li><li>High school graduate or equivalent. </li><li>Two years experience in a medical or rehab office, clinic, or comparable hospital experience utilizing insurance company websites required. </li><li>1 year experience working with third party payors including referral and authorization requirements. </li><li>Successful passage of basic medical terminology course OR successful passage of the CCH Medical Terminology exam. </li><li>Keyboarding skills at 35 WPM as demonstrated by successful passage of a timed test. </li><li>1 year experience with hospital, clinical or medical office based information system. </li><li>Basic mathematics skills and ability to apply skills, as demonstrated by successful passage of a timed business math test, using manual and aided computations to solve problems. </li></ul>