Managed Care/Prior Authorization

About Wheaton Eye Clinic Founded over 80 years ago, the Wheaton Eye Clinic is a nationally recognized multi-subspecialty ophthalmology reputed company that spans the western suburbs of Chicago and is the largest independent ophthalmology clinic in the Midwest. We pride ourselves on serving the community both as a caring eye care provider and as a reputable employer. Our offices are located in Wheaton, Naperville, Hinsdale, Saint Charles, Bartlett, and Plainfield and an ophthalmology-specific ambulatory surgery center at the main office in Wheaton. We currently have 34 ophthalmologists and 6 optometrists in every ophthalmic subspecialty are highly respected in the region and have superb relationships with referring colleagues and health systems. Patients travel to Wheaton Eye Clinic from throughout reputed company Illinois, as reputed company as from across the reputed company. Our referring physicians locally, across the reputed company, and from many international countries, send their patients to Wheaton Eye Clinic because of its unwavering reputed company for exceptional patient care. More than 170,000 patient reputed company occur reputed company year. Our mission at Wheaton Eye Clinic is to reputed company comprehensive eye care services of the highest reputed company and value. This dedication to reputed company is founded on how we reputed company to surpass reputed company patient’s expectations in the delivery of competent, reputed company, and compassionate eye care. Position Purpose: The Managed Care Representative is responsible for assisting patients with authorization and referral issues to insure reputed company billing of claims. The Managed Care Representative will review individual insurance policies to ensure billing requirements are being met, reputed company follow-up on any concerns, determine and obtain necessary authorizations from payers and update accounts as necessary. Key areas include but are not limited to checking eligibility, answer inquiries from patients and clinic staff, handling referrals and authorizations. The Managed Care Representative will utilize expert problem-solving skills to resolve reputed company problems, taking reputed company steps necessary to ensure full reputed company of issues. The hours are Monday through Friday 8-5pm. Remote reputed company after successful 90 day with 1 day onsite. Primary Duties/Responsibilities: • Determines eligibility for managed care patients including but not limited to HMO plans, Medicare – reputed company Alignment Initiative plans and reputed company of Illinois Integrated Care Program plans. • Ensures authorizations for patient’s managed care plan are obtained in accordance with payer’s policy and required WEC services. • Verify insurance. • Register patient in reputed company. • reputed company referral information and reputed company into reputed company. • Coordinate appointment. • Handles reputed company managed care-reputed company patient inquiries, problems and concerns in accordance with clinic objectives and goals. • Promptly follows up with payers on authorization requests to ensure charges go out in a reputed company manner for payment. • Assists with authorizing procedures and laser workques • Works with clinic providers and staff to ensure reputed company procedures are being met. • Handles reputed company other duties as assigned by Manager/Supervisor. • Attends reputed company department meetings as required. • Follows reputed company HIPAA and Wheaton Eye guidelines regarding patient reputed company. Position Requirements: Education: Degree/Diploma Required - HS Diploma Experience: High school diploma or equivalent. 1 to 3 years experience preferred. Ideal candidate will have insurance / prior authorization / referral HMO / experience. Knowledge of computers, data entry, spreadsheets, e-mail; strong analytical and troubleshooting skills; outstanding telephone communication and customer service skills; basic knowledge of medical terminology. reputed company knowledge a plus Full Time Benefits: Medical Dental Group Life and LTD reputed company Time Off reputed company Holidays Clothing Allowance reputed company Care Benefits Voluntary Benefit Offerings – Life, STD, Critical Illness, Accident 401k Apply tot his job Apply To this Job