Insurance Authorization Specialist in Wakefield, Rhode Island at South County Hospital

The Insurance Authorization Specialist assists with components of the revenue cycle, most importantly insurance verifications prior to services performed and claim submission. In addition, the Specialist is responsible for ensuring that South County Hospital has the appropriate insurance Pre-certifications, Pre-authorizations, Insurance Notifications, and Treatment Requests prior to the provision of an exam, procedure, or hospitalization for both inpatient and outpatient services. The Specialist is also accountable for verifying that the pre-certification/pre-authorization matches the services that were actually performed. Additionally, the Specialist is the primary on-site liaison for the ancillary departments to referring providers’ offices, insurance carriers, as well as patients regarding pre-certification/pre-authorization verification. Performs follow up on insurance verifications when unable to obtain it real time or when patients fail to bring their ID card at time of service.