Shirley Ryan AbilityLab

Insurance

• Research and verify financial coverage with third-party payers for planned services prior to patient's scheduled appointment, which includes completing authorization requirements for the patient's specific plan and communicating limitations or denials to patient/family
• Refer cases to outpatient Care Managers or Social Workers when patients are unable to pay for services or services are not covered under a third-party payer.
• Document receipt and forwards appropriate forms (such as a primary care physician referral or a signed agreement to self-pay) to Patient Financial Services.
• Document all financial clearance information in Information System.
• Coordinate Clinic referral and authorization processes including expediting response to referral inquiry, insuring benefits are available, obtaining insurance authorization, assessing clinical information of referral and obtaining social and demographic information to support.
• Screen and respond to requests for general information regarding SRAlab services and programs.
• Identify and verifies patient benefits and initiates the pre-certification process by accessing insurance company, Medicare, and/or Medicaid data bases.
• Identify and implements improvements to enhance efficiency and outcomes and to solve unique or complicated problems.
• Update demographic, insurance, funding and medical information in SRAlab's Information System, as needed.
• Communicate information to the outpatient clinical team or SRAlab inpatient Care Managers as needed.
• Communicate all actual or potential denials to Financial Clearance Supervisor.
• Perform all other duties that may be assigned in the best interest of SRAlab.

Insurance Coordinator