Registration Specialist Job in Boston, Massachusetts US
Registration Specialist
Job Description Under the direction of the Practice Manager and the Physicians, the Prior Authorization Registration Specialist is responsible for obtaining authorizations for all office and surgical procedures. The primary role is to verify whether or not a prior authorization/precertification is required by the patient?s insurance carrier. Submit a letter of medical necessity along with clinical documentation to the insurance carrier. Perform any required follow-up on submitted prior authorizations. Notify practice of approvals or denials in a timely manner. Prior Authorization Submission: - Work closely with PSCII to obtain patient information from practice for upcoming procedures. -Verify need for authorization/precertification via insurance carrier. -Draft and submit letter of medical necessity and clinical documentation to insurance carrier in a timely fashion. Include ICD-9 or -10 as well as CPT codes. -Provide required follow-up to check on status of prior authorization. -Notify practice of any approvals or denials in a timely fashion Workers Compensation Authorization Submission: -Work closely with PSCII to obtain patient information from practice for upcoming procedures. -Draft and submit letter of medical necessity with procedure fees and clinical documentation in a timely fashion. Include ICD-9 or -10 as well as CPT codes. -Provide required follow-up to check on status of prior authorization. -Refer insurance fee questions or denials to physician for fee negotiation and provide acceptance or feedback information to insurer. -Notify practice of any approvals or denials in a timely fashion. Requirements - Knowledgeable with CPT and ICD-9 coding and terminology - Good communication skills (oral and written) - Adheres to the Department of Surgery?s required annual trainings. - Good time management skills - Completes assigned tasks in a timely fashion. - High school diploma or equivalent required - Associates degree preferred One year of experience working in a medical or insurance office or related setting where work includes one or more of the following: medical secretary, patient registration, insurance verification/eligibility or billing.