Insurance Verification/Authorization Intake Specialist

Insurance Verification Specialist Home Care
First Option Health Care Services

Home Health & Home Infusion

Insurance Verification/Authorization Intake Specialist

The Way Home Care Should Be

Ready to join a locally owned Homecare Provider with over 39 years in the industry? Want to be a member of an organization in a role where you are able to utilize your skills in a dynamic setting? Maybe it is time for you to work for an organization that will inspire you to be the best team member that you can. Work with an amazing team and organization that takes care of patients in Acadiana in the manner that makes you proud.

• Two years of insurance verification/authorization experience in a healthcare environment (Required)
• High school or equivalent (Required)
• US work authorization (Required)
• Customer Service: 1 year (Preferred)

Full Job Description

Position Summary:

Insurance Verification/Authorization Intake Specialist are responsible for learning and understanding the entire front-end process to ensure successful service for our patients. The coordinator works in a fast-paced environment answering inbound calls and making outbound calls. Maybe responsible for obtaining, analyzing, and verifying the accuracy of information received from referrals. The Specialist will educate Patients of their financial responsibility when applicable.

Essential Functions and Job Responsibilities:

• Develop and maintain working knowledge of current products and services offered by the company
• Review all required documentation to ensure accuracy
• Maintains an extensive knowledge of different types of payer coverage and insurance policies
• Responsible for verifying patient insurance coverage, to ensure necessary procedures are covered by the individual’s insurance accurately
• Complete insurance verification to determine patient’s eligibility, coverage, co-insurances, and deductibles and communicate this process to the referral source.
• Obtain pre-authorization if required by an insurance carrier and process physician orders to insurance carriers for approval, authorization, and re-authorization when required
• Resolves any issues with coverage and escalates complicated issues to the team’s manager
• Completes accurate patient demographic and insurance entry into EMR database to include payer, authorization requirements and coverage limitations and expiration dates as needed
• Position requires staff to spend extensive amounts of time on the phone or on payer websites with insurance companies
• Must be able to navigate through multiple online EMR systems to obtain applicable documentation
• Communicate with Customer Service and Management on an on-going basis regarding any noticed trends with insurance companies
• Verify insurance carriers are listed in the company’s database system, if not, then report to team manager
• Responsible for contacting patient when documentation received does not meet payer guidelines to provide updates and offer additional options to facilitate the referral process.
• Pays attention to detail and has great organizational skills
• Actively listen to patients and handle stressful situations with compassion and empathy
• Flexible with the actual work and the hours of operation
• Utilize company provided tools to ensure accuracy for billing directives. Some tools may include but are not limited to Authorization Guidelines, Insurance Guidelines, Fee Schedules, NPI

(National Provider Identifier), PECOS (the Medicare Provider Enrollment, Chain, and Ownership System) and “How-To” documents

• Maintain patient confidentiality and function within the guidelines of HIPAA
• Completes assigned compliance training and other educational programs as required
• Participate in educational programs as required
• Perform other related duties as assigned

Competency, Skills and Abilities:

• Excellent customer service skills
• Decision Making
• Excellent ability to communicate both verbally and in writing
• Ability to prioritize and manage multiple tasks
• Proficient computer skills and knowledge of Microsoft Office
• Solid ability to learn new technologies and possess the technical aptitude required to understand flow of data through systems as well as system interaction
• General knowledge of Medicare, Medicaid, and Commercial health plan methodologies and documentation requirements preferred.
• Work well independently and as part of a group
• Ability to adapt and be flexible in a rapidly changing environment, be patient, accountable, proactive, take initiative and work effectively on a team

Education and Experience Requirements:

• High School Diploma or equivalency
• One (1) year work related in health care administrative, financial, or insurance customer services, claims, billing, call center or management regardless of industry is required.
• Exact job experience is considered any of the above tasks in a Medicare certified home health and/or infusion environment that routinely bills insurance.

Physical Demands and Work Environment:

• Work environment may be stressful at times, as overall office activities and work levels fluctuate
• Must be able to bend, stoop, stretch, stand, and sit for extended periods of time
• Subject to long periods of sitting and exposure to computer screen
• Ability to perform repetitive motions of wrists, hands, and/or fingers due to extensive computer use
• Must be able to lift 30 pounds as needed
• This position if primarily performed within an office building
• Excellent ability to effectively communicate both verbally and written with customers with the ability to demonstrate empathy, compassion, courtesy, and respect for privacy

Schedule: Monday- Friday 8:00 am- 5:00 pm

Job Type: Full-time

Schedule:

• 8-hour shift
• Monday to Friday

If you require alternative methods of application or screening, you must approach the employer directly to request this as really is not responsible for the employer's application process.

Job Types: Full-time, Part-time

Pay: $18.00 - $22.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Disability insurance
• Health insurance
• Life insurance
• Paid time off

Education:

• High school or equivalent (Required)

Experience:

• Insurance Verification: 1 year (Required)

Work Location: In person

Salary : $18 - $22