The Insurance Supervisor is responsible for processing all prescription orders. Position performs the insurance verification and authorization process. In addition, this position is responsible for developing, documenting, and revising departmental policies, procedures and processes, as well as, training other departmental employees. Responsible for meeting established department and company goals and objectives.
Duties and Responsibilities:
Supervises the Insurance team
Collaborates with Director of Reimbursement to create individual and team goals, and team matrixes
Conducts performance review
Prepares and assists in the preparation of the narratives, graphs, flowcharts, etc. To be utilized for presentations and/or reports.
Assists with interdepartmental issues to help coordinate problem solving in an efficient and timely manner.
Creates and/or maintains statistics and reporting.
Processes all prescription orders and determines risk of shipping prior to obtaining an authorization
Becomes a backup Insurance Specialist when employee is out sick and/or on vacation, duties are: handling incoming customer calls, calling payers for in-depth insurance verification, working on prior-authorization requests and calling payers to following up on prior authorization submitted.
Measure and Evaluate team s tasks and workload.
Coordinates with other team members all information needed from Healthcare Teams and Customers/Guardians, based on medical criteria and information needed by payer source, to expedite the authorization process
Functions as primary expert to explain patient insurance benefits Interacts with Business Development team and internal teams to create a remarkable experience for Customers and potential Customers and to maximize business opportunities
Develops, documents, and revises departmental policies, procedures and processes to ensure efficient and effective processing of customer orders and customer experience
Trains departmental employees as need arises.
Interacts heavily with Provider Relations and Network Specialist on specific payer source issues and to implement operational changes to address specific payer requirements, when needed.
Cross trains with other team members
Attends HIPAA training and other training sessions as they arise or are required
Performance of additional duties as assigned
Prefer 4 year college degree
Minimum 5 years supervising/management experience and third party payer experience, preferably in a DME setting
Demonstrated high-level customer service skills
Excellent communication skills, both verbal and nonverbal
Strong analytical and problem solving skills
Ability to organize and prioritize workload
Ability to work independently and as part of a team
Strong knowledge of word processing, spreadsheet, and database software
Physical Requirements of the Position:
Candidate must be able to sit at computer desk in front of a PC monitor for long periods of time. Position requires incumbent to use a PC, telephone, and basic office equipment. Position requires ability to hear phone conversations, read medical and insurance information and communicate clearly with all levels of internal and external customers.