Home Therapy Insurance Continuity Specialist

Ethos Therapy Solutions; Center Square (PA); On-site; USD 42,000 - 56,000; Full time

Job summary

Ethos Therapy Solutions in Center Square, PA is seeking a Continued Qualification Specialist to obtain insurance documentation for continued therapy and to coordinate transitions. You will work closely with patients, caregivers, clinical referral and payer sources to ensure smooth billing and authorization processes.

The role requires strong communication, knowledge of insurance policies, HIPAA compliance, and the ability to collaborate with multiple stakeholders to minimize patient and payer

Qualifications

• Experience in insurance verification within a medical/healthcare setting.
• Knowledge of CPT codes and ICD-10 coding system.
• Familiarity with HIPAA and patient confidentiality.
• Proficient in using EHR and billing software.
• Strong communication and organizational skills.

Responsibilities

• Obtain all necessary documentation required by the patient’s insurance provider for continued therapy.
• Coordinate continued or transitioned therapy and billing processes.
• Assess eligibility for therapy as per insurance guidelines and coverage.
• Collaborate with billing to ensure accurate and timely claim submissions.
• Maintain real-time records of patient demographics, insurance information and authorizations.
• Escalate cases that may delay claims or unbilled claims.
• Ensure compliance with federal and state regulations and guidelines.
• Identify opportunities to improve qualification processes.

Skills

Communication

Insurance knowledge

Collaboration

HIPAA compliance

Customer service

Problem solving

Education

High school diploma

Healthcare admin education preferred

Tools

EHR systems

Billing software

Insurance databases

Job description

Ethos Therapy Solutions in Center Square, PA is seeking a Continued Qualification Specialist to obtain insurance documentation for continued therapy and to coordinate transitions. You will work closely with patients, caregivers, clinical referral and payer sources to ensure smooth billing and authorization processes.

The role requires strong communication, knowledge of insurance policies, HIPAA compliance, and the ability to collaborate with multiple stakeholders to minimize patient and payer