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Northeast Georgia Health System is rooted in a foundation of improving the health of our communities.

About the Role:

Job Summary

The Outpatient Rehab Insurance Specialist works under the supervision of the Rehab Office Supervisor. Once a referral is received for OP rehab at Sherwood, the Insurance Specialist is responsible for ensuring that all rehab accounts (ortho and neuro) are verified and authorization is obtained, when applicable, prior to the actual scheduled procedure. The Insurance Specialist must accurately collect and input patient and insurance information into various NGHS databases to ensure accurate billing and ensure complete medical record attainment.

Minimum Job Qualifications

• Licensure or other certifications:

• Educational Requirements: High School Diploma

• Minimum Experience:

• Other:

Preferred Job Qualifications

• Preferred Licensure or other certifications:

• Preferred Educational Requirements:

• Preferred Experience: Medical terminology, data entry and computer experience, admitting, business office, collection, Physician office experience, working with public. Bilingual preferred.

• Other:

Job Specific and Unique Knowledge, Skills and Abilities

• Excellent written and oral communication skills required

• Must be able to multitask, coordinating more than one event at a time

• Must be able to type 35-45 wpm

• Proficient in the use of office equipment (computer, fax, telephone, scanning copier)

• Must be able to demonstrate a working knowledge of Rehab billing requirements

• Must possess detailed understanding and knowledge of insurance guideline and protocols, the components of full verification, and payer information / requirements

• Excellent interpersonal skills

• Ability to serve as a resource for all registration personnel

• Ability to prioritize, organize, and coordinate daily work load

• Exhibits competency in the use of all registration systems, electronic verification tools, and Web Based resources

Essential Tasks and Responsibilities

• Performs Pre-Registration functions for multiple departments.

• Spends greater than 50% of daily work time on phone or internet sites of insurance companies.

• Completes Prior Authorization & Verification of benefits. Obtains relevant billing information from insurance company prior to patient's visit to include co-payment, deductible, co-insurance, annual visit limit.

• Completes Case Management of continuing treatment (re-authorization)

• Manages a high volume of Medicaid patients frequently accessing web portal. Completes the appropriate forms and documentation.

• Verifies eligibility for Active Medicaid patients each month.

• Complete Retro-Authorization report for all rehab locations.

• Provides coverage and support for the front desk as needed.

• Coordinates and communicates ongoing insurance status with therapist.

Physical Demands

• Weight Lifted: Up to 20 lbs, Occasionally 0-30% of time

• Weight Carried: Up to 20 lbs, Occasionally 0-30% of time

• Vision: Moderate, Occasionally 0-30% of time

• Kneeling/Stooping/Bending: Occasionally 0-30%

• Standing/Walking: Occasionally 0-30%

• Pushing/Pulling: Occasionally 0-30%

• Intensity of Work: Occasionally 0-30%

• Job Requires: Reading, Writing, Reasoning, Talking, Keyboarding

Working at NGHS means being part of something special: a team invested in you as a person, an employee, and in helping you reach your goals.

NGHS: Opportunities start here.

Northeast Georgia Health System is an Equal Opportunity Employer and will not tolerate discrimination in employment on the basis of race, color, age, sex, sexual orientation, gender identity or expression, religion, disability, ethnicity, national origin, marital status, protected veteran status, genetic information, or any other legally protected classification or status.