Initiates and maintains a high level of customer service and positive employee relationships.
Responsible for obtaining authorization for all disciplines for Home Care Services; inclusive of verification of insurance and benefits to ensure appropriate reimbursement from commercial payers, government payers and state agencies.
Strong knowledge of verifying and allocating accurate insurance plans; ability to utilize electronic eligibility tools, accessing web portals, & making phone calls to payers to ensure accurate coverage is obtained.
Effectively and professionally communicates with internal and external customers via emails, telephone, and doc halo.
Ability to document appropriately all findings/statuses from Insurance payers and/or government agencies in certified software systems employed by the agency.
Effectively collaborates with other closely related departments such as Intake Referral Team, Revenue Cycle, Clinical Managers and Patient Services Coordinators.
Ensures compliance with department productivity and quality standards; ability to effectively manage varying workloads.
This position will require working rotating weekends and holidays as needed by department volume.
Performs other duties as assigned.
Complies with all policies and standards.
For specific duties and responsibilities, refer to documentation provided by the department during orientation.
Must abide by all requirements to safely and securely maintain Protected Health Information (PHI) for our patients.
Annual training, the UH Code of Conduct and UH policies and procedures are in place to address appropriate use of PHI in the workplace.
Monday-Friday with rotating weekends and holidays.
After the 90 day new hire orientation this position will become hybrid.
Orientation is mandatory onsite.
This is the day shift and will be 8:00 AM to 4:30 PM or 8:30 AM to 5:00 PM.
This position is in home care services.
Qualifications
High School Equivalent / GED required and
Medical terminology courses preferred.
3+ years experience in the hospital/post-acute insurance setting required.
Strong organizational skills and a high level of accuracy are required.
Knowledge of Medicare and Medicaid regulations and reimbursement.
Strong knowledge of medical terminology.
Strong knowledge of Commercial Insurance rules and regulations.
