Full-Time Insurance Specialist

Trinity Health Mid-Atlantic; Livonia (MI); On-site; USD 60,000 - 80,000; Full time

Job summary

A leading healthcare provider is seeking a Full-Time Insurance Specialist to manage referrals and billing processes. The role involves ensuring accurate insurance verifications and compliance with regulations while providing excellent customer service. Benefits include health insurance, daily pay, and tuition reimbursement.

Benefits

Health, dental and vision insurance

Daily Pay

Employee Referral Reward Program

Short and long-term disability

Tuition Reimbursement

403b

Generous paid time off

Comprehensive orientation

Qualifications

• Two years of experience in coverage verification/benefit determination preferred.
• Knowledge of governmental reimbursement criteria.

Responsibilities

• Processes all incoming referrals ensuring efficient and accurate order processing.
• Compiles financial data for client insurance verification.
• Maintains knowledge of insurance regulations and criteria.

Skills

Communication

Customer Service

Education

High School diploma

Two years college experience

Tools

Agency’s current software

Job description

Full-Time Insurance Specialist page is loaded

Full-Time Insurance Specialist

Apply locations Trinity Health At Home Service Center - Livonia, Mi Saint Joseph Mercy Health System Hospital Campus - Livonia, Mi time type Full time posted on Posted 2 Days Ago job requisition id 00579611

Employment Type:

Full time

Shift:

Description:

Mon. - Fri. 12:30pm to 8pm (rotating every 5th weekend 8am to 4:30pm)

Position Purpose:

The Insurance Specialist is responsible for processing all incoming referrals received by THHS Central Intake ensuring the orders are processed in an efficient and accurate manner. Responsible for the creation and verification of all client account billings to all third party and private payers utilizing the appropriate software programs. Compiles financial data required to verify accuracy of the client’s fee source/method of payment to assure timely reimbursement. Obtains initial and ongoing authorization for services as appropriate. Documents payer source data and authorization activity to online billing system. Required to comply with all HCFA/JCAHO/Compliance regulations. In addition, the position provides assistance to the clinical customer service coordinator and THHS billing departments related to special projects, audits and regular monthly reporting. Will support multiple sites.

What You Will Do:

• Compiles financial data required to verify accuracy of client insurance/payer source/method of payment to asst. Documents payer source data and authorization activity in online billing system to ensure accurate and timely submission of claims.

• Stays current with all third-party insurance regulations and criteria.

• Able to effectively respond to clients/families/staff and others regarding insurance questions and concerns.

• Confers with referral sources as needed in relation to alternative fee sources/funding.

• Demonstrates accuracy and completeness in all data entry and reports.

• Maintains a working knowledge of applicable Federal, State, and local laws and regulations, Trinity Health Organization Integrity Program, Code of Ethics, as well as other policies and procedures to ensure adherence in a manner that reflects honest, ethical, and professional behavior.

• Assists in the referral processing of all THHS clients from receipt of referral through the insurance verifications of all third-party payers. Assures the creation, accuracy, and maintenance of all client account insurance activity.

• Provides direction and on-going assistance to site team staff relating to the client’s insurance qualifications needed to assure accurate revenue to agency.

• Is proficient at the use of automated tools and makes appropriate decisions related to the relationship of the action required and the tool used.

• Obtains initial authorization, if appropriate. Audit authorizations for accuracy and determine if delay/deny policy needs to be invoked.

Benefits:

• Day 1 Benefits - Health, dental and vision insurance

• Daily Pay

• Employee Referral Reward Program

• Short and long-term disability

• Tuition Reimbursement

• 403b

• Generous paid time off

• Comprehensive orientation

• Pay range: $17.87 - $22 per hour plus $3 shift differential pay

Minimum Qualifications:

• High School diploma or equivalent: two years college experience preferred.

• Two years of experience in coverage verification/benefit determination preferred. Two years home care experience preferred.

• Knowledge of governmental reimbursement criteria. Knowledge of third party / managed care contracts related to Agency services is preferred.

• Computer literate. Experience with Agency’s current software platforms preferred.

• Working knowledge of standard office equipment.

• Must be able to communicate effectively with internal and external customers.

• Demonstrates a commitment to customer service and accepts challenges to improve processes.

• Ability to consistently demonstrate commitment to the mission and Organizational Code of

• Ethics, and adhere to the Compliance Program.

Apply Today!!!!

Our Commitment to Diversity and Inclusion

Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.

About Us

Trinity Health is one of the largest not-for-profit, faith-based health care systems in the nation. Together, we’re 121,000 colleagues and nearly 36,500 physicians and clinicians caring for diverse communities across 27 states. Nationally recognized for care and experience, our system includes 101 hospitals, 126 continuing care locations, the second largest PACE program in the country, 136 urgent care locations, and many other health and well-being services. Based in Livonia, Michigan, in fiscal year 2023, we invested $1.5 billion in our communities through charity care and other community benefit programs.