Job Title
Insurance & Authorization CoordinatorLocation
Remote/Nationwide, USAAdditional Location(s)
Employee Type
EmployeeWorking Hours Per Week
40Job Description
Homecare Homebase Experience (HCHB) is strongly preferred.
Hours: Monday - Friday 8:30AM - 5PM, (MUST LIVE IN CENTRAL TIME ZONE TO BE CONSIDERED). MUST BE WILLING TO WORK EVERY OTHER SATURDAY.
Compensation: $18.00 - $22.00.
The base compensation range for this role is fixed, with a maximum cap of $22.00. We want to be transparent about this as we continue discussions.
Medical Benefits: Health, Vision, & Dental
Retirement: 401K & Pension w/ 4% employer contribution
PTO: 15 Days
The Insurance Verification & Authorization Coordinator ensures that benefit information, authorization, and patient liability are obtained prior to clinical staff starting care for any service lines and branches. Work closely with other departments to ensure that correct funding source information is updated in a timely manner. Daily tasks will be driven by assigned workflow in the EMR (Homecare Homebase).
INSURANCE VERIFICATION & AUTHORIZATION COORDINATOR DUTIES AND RESPONSIBILITIES:
Obtain detailed and accurate benefit information using payer portals, phone, or fax for all insurance companies accepted by Home Health product lines
Validate and document all payor information such as patient name, DOB, and policy number in the EMR
Reduce write-offs by clearly documenting benefit information such as deductibles, co pays, co-insurance, and out-of-pocket maximums in the patients’ charts through coordination notes
Continuously monitor task flow screen related to all insurance issues including but not limited to the following: verify Medicare eligibility, follow up to on-call completed insurance, complete insurance verification, review eligibility alerts, obtain initial authorization, re-verify insurance at recertification, and resumption of care
Review of entitlement verification reports daily, researching any questionable answers
Review problems related to all insurance changes daily
Review of issues related to funding source updates daily
Reverify current Medicaid patients to monitor HMO status monthly
Reverify current patients’ insurances monthly to monitor for any payer changes or other agencies monthly
Contact patients, hospitals, or physician offices for information or to clarify benefit
Assist scheduling with funding source problems related to scheduling out visits to clinical staff
Reduce write-offs by working with the clinical staff to ensure transfer of agency/provider of choice forms are received and sent to the other agency within the appropriate timeframes
Obtain detailed and accurate authorization, prior authorization, and ongoing authorization as required by insurance companies accepted by the company via phone, fax, or payer portal
Understand and maintain the authorization tab in HCHB
Provide clinical information as requested by insurance companies
Contact insurance companies as needed to review authorization submissions and requests for more clinical information and notify internal clinical staff of authorization approvals and denials
Continuously monitor task flow screen related to all authorization issues including, but not limited to the following: determine if reauthorization needed for new orders, follow up on on-call completed authorizations, obtain initial authorization, obtain reauthorization, and update pending authorization with actual authorization information
Assist scheduling with funding source problems related to scheduling out visits to clinical staff
Assist billing department insurance verification discrepancies or authorization discrepancies which could hold up claim submission
Establish a thorough knowledge of all payer portals
Comply with the company’s Core Values and Core Competencies
Perform other duties as assigned
INSURANCE VERIFICATION & AUTHORIZATION COORDINATOR:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Associate degree or combination of experience and business courses preferred
Minimum of one (1) year of previous experience in insurance verification, authorization, or medical billing
Proficiency in Microsoft Office Suite
Knowledge of Medicare, Medicaid, and third-party insurance and authorization requirements
Knowledge of insurance websites
Knowledge of HomeCare Homebase preferred
Conscientious, with attention to detail
Demonstrated patience, flexibility, and cooperative attitude
Ability to think critically and act independently when resolving benefit discrepancies
Effective verbal and written communication skills with others both internally and externally
Ability to work independently and within a multidisciplinary team
Availability weekends, holidays, and after hours based on business needs
CERTIFICATES, LICENSES, REGISTRATIONS
Must have and maintain in good standing a professional license, certificate, or registration, as applicable.
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, climb stairs, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.
The employee frequently lifts and/or moves up to 20 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
This job generally operates in a clerical office setting. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets, and fax machines. While performing the duties of this position, the employee may travel by automobile and be exposed to changing weather conditions.
This description is intended to describe the essential job functions, the general supplemental functions, and the essential requirements for the performance of this job. It is not an exhaustive list of all duties, responsibilities, and requirements of a person so classified. Other functions may be assigned, and management retains the right to add or change the duties at any time.
About Graham Healthcare Group:
As an innovator in an evolving healthcare world, Graham Healthcare Group has been designing business and technology solutions to drive better care, outcomes, and productivity within its own home health and hospice companies for over 20 years. In the last several years, our solutions have been successfully integrated across the healthcare continuum.
Join the Graham Healthcare Group and enjoy the following benefits:
Competitive Pay: With opportunity for advancement
Health and Welfare Benefits: Various medical, dental, and vision insurance options for you and your family to choose from.
Supplemental Benefits: Company paid life insurance and disability benefits. Also, pre-tax FSA and HSA plans are offered.
Generous PTO Packages.
Retirement: Save for your future with our company offered 401k plan and pension.
Company-Paid Education Programs: Grow your career by taking advantage of 50% discounts on tuition for selected courses offered by Purdue and Kaplan.
Benefits may vary based on your employment status.
NOTICE:
Successful completion of a drug screen prior to employment is part of our background process, which includes medical and recreational marijuana.
By supplying your phone number, you agree to receive communication via phone or text.
By submitting your application, you are confirming that you are legally authorized to work in the United States.
Graham Healthcare Group is an Equal Opportunity Employer
Graham Healthcare Group is a home healthcare provider that operates multiple service lines and branches delivering in-home clinical services to patients. The company utilizes Homecare Homebase (HCHB) as their electronic medical records system to manage patient care coordination and insurance verification processes. They accept multiple insurance types including Medicare and Medicaid, and coordinate benefits verification and prior authorizations across various payers to ensure proper funding and patient eligibility before clinical staff initiate care services.
