Versant Health

About Versant Health

APPLY DIRECTLY HERE: https://usr57.dayforcehcm.com/CandidatePortal/en-US/versanthealth/Site/VersantHealth/Posting/View/2443 Versant Health bringing you Davis Vision and Superior Vision is a leading provider of vision and eye health solutions. We offer a full spectrum of services in the vision care marketplace. Our mission is very real to our members: we help them enjoy the wonders of sight through healthy eyes and vision. What you do as a Versant Health Associate matters. 33 million Americans count on us to provide access to annual eye exams and corrective eyewear. We are here to change the face of vision care, and together we will make this happen. Great Environment We are dedicated to you - we provide a professional work environment, competitive benefits, equal opportunities and potential to grow with us. We guide you to what’s right for you - as leaders in the industry, we guide and coach Associates to give them opportunities to reach their full professional potential. We think ahead for you - you’ll enjoy a variety of benefits for those times when you need extra support. Scope and Purpose of Position The Prior Authorization Representative will focus on the coordination of the prior authorization process by responding to telephone inquiries and faxes from members and/or providers for ophthalmology services. The Prior Authorization Representative will assist with the coordination of durable medical equipment, and nonstandard eyewear and services authorization. They will also assist in the routine verification of eligibility and confirmation of benefits. Essential Functions Authorization of surgical requests according to set plan guidelines Respond to telephone inquiries from members and/or providers for Optometry and Ophthalmology services as well as DME Verification of eligibility, confirmation of benefits, facilitation of the referral/authorization processes Direct communication with the Medical Director with regard to surgical authorizations and non-standard services Preparation and coordination of denial letters Assist with other duties as may be assigned Create and maintain master spreadsheet to record all surgical procedures, denials, approvals Other duties as assigned Education & Experience High school graduate or equivalent required Prior Authorization or medical insurance processing/billing experience required Previous Optometry and/or Ophthalmology experience preferred Competencies Computer literate with an emphasis on MS Office products required, with emphasis on Microsoft Excel Highly organized individual with a strong attention to detail Excellent customer service and phone communication skills (friendly, courteous and helpful) Excellent interpersonal verbal and written communication skills Well organized and resourceful Accurate and efficient data entry skills Strong resolution and follow-up skills Skilled in dealing with all customers in an efficient and effective manner We provide equal employment opportunities (EEO) to all associates and applicants for employment without regard to race, color, religious beliefs, sex, gender identity, sexual orientation, age, marital status, national origin, ancestry, physical or mental disability or history of disability, genetic information, status as a protected veteran or disabled veteran, or any other status protected by Federal, state or local law. If you are prohibited from working on a government contract, this may disqualify you from consideration for this position. Job Type: Full-time Work Location: One location Benefits: Health insurance Dental insurance Vision insurance Other Schedule: Monday to Friday

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Company Info

Legal Form: Inc

Company Type: Private

Company Size: 1001 - 5000

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Job Ads found: 78

Job Ads per Month: 3.5

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