Patient Financial Services Specialist, IV/Auths (REMOTE)

Job Title: PFS Specialist, Front-End (IV/Auths)

Job Location Details

Client Location: Aliso Viejo, CA

Work Location: REMOTE

Salary Expectations/Pay Rate or Range: $22.00-$25.00/hr **depending on experience

Job Description:

The Patient Financial Services (PFS) Specialist is responsible for the timely completion of the insurance verifications and/or authorizations in a high production environment. In this role the PFS Specialist must verify the patient's insurance coverage and/or authorizations for specialty medical testing.

Responsibilities/ Job Duties:

• Verifies insurance coverage benefits including deductible, co-insurance, and out-of-pocket maximum amounts to estimate the out-of-pocket potentially owed by the patient for services
• Verifies insurance coverage for genetic testing based on CPT and ICD-10 codes and determine whether authorization is required
• Works exceptions/rejections from automated eligibility systems
• Send authorization requests for genetic testing with the appropriate documentation to the patient's insurance
• Follow-up on authorization statuses on a weekly basis
• Contact clients for missing documentation required by the patient's insurance
• Coordinates with other contracted vendors to assist in obtaining timely and accurate prior authorizations
• Identifies payer web sites or other methods to verify insurance coverage benefits and/or submit authorization requests
• Trends and reports payer related issues regarding insurance verifications and/or denied authorization requests for genetic testing
• Reports to other team members beneficiary coverage issues for process improvements
• Other projects as assigned

Minimum Education and Experience Requirements:

• 2+ years of insurance and authorization experienece

• Strong understanding of benefits and ability to calculate deductibles / out of pocket owed

• Experience working on IVS/Auth from the provider (med group, hospital, third party, etc.) side

• Knowledgeable of Ancillary Rules

Schedule/ Shift: M-F, can start as early as 6am PST or as late as 9am PST ***REGARDLESS OF RESIDING TIMEZONE

Initial 2-3+ weeks of training schedule is M-F, 7am-3:30pm PST.

Benefits:

• Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances)

• Health Benefits / Dental / Vision (Medix Offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s).)

• 401k (eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1)

• Short Term Disability Insurance

• Term Life Insurance Plan

About Medix?

Medix is dedicated to positively impacting lives every day. Since 2001, we have made it our mission to be the leading provider of workforce solutions for clients and candidates across the Healthcare, Scientific, and Information Technology industries.
Our dedicated recruiters are here to help you find and secure just the right opportunity. We take the time to learn about you, your skills, your interests, and your career goals, and then match you with the jobs and companies that best suit your needs. Whether you are looking for a contract, contract-to-hire, or direct hire positions, we can help you to find the meaningful and gratifying work that you've been looking for.

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Medix is acting as an Employment Business in relation to this vacancy.