Verifies insurance eligibility and benefits of prospects/ referrals and determines LHC rate requirements as it relates to in or out of network coverage on a daily basis in an accurate and timely manner.
Communicates patient benefits in a timely manner using the appropriate legacy system and associated software application as found in patient notes, tasks, workflow, email and or phone calls with our agencies.
Documents and forwards patient deductible, out-of-pocket expense, life time maximum, home health or hospice days, and patient responsibility to agency in an accurate and timely manner.
Reviews and replies to branch location’s urgent requests in a timely and accurate manner.
Initiates one time letters of agreement (LOAs) and negotiates rates as dictated by established policies and procedures in a timely manner.
Obtains all authorization as needed from payer for services ordered/requested in a timely manner.
Documents specific details related to the authorization including effective and end dates using the appropriate legacy system and associated software application via patient notes, authorizations, tasks, workflow, phone calls and/or email.
Serves as a liaison between the branch location and the payer on a regular basis.
Coordinates and communicates with the branch location regarding any changes or updates from the payer in a timely manner.
Manages work assignment to ensure all tasks and coordination notes are completed in a timely manner.
Resolves all customer requests, inquiries, and concerns in an expedient and respectful manner.
Problem solves independently before referring issues to the Supervisor/Manager for resolution.
Performs eligibility and or similar, comparable, or related duties as may be required or assigned.
Qualifications:
Education and Experience:
Formal Education:
High School Diploma or equivalent
Experience:
1 year
Insurance verification and authorization experience required.
Revenue cycle experience desired.
Skill Requirements:
Excellent oral and written communication skills.
Excellent organizational and analytical skills.
Independent thinker.
Skills Desired:
Basic PC skills including PC based applications (MS Word, Excel).
