Hospice Insurance Verification & Authorization Coordinator

Allegheny Health Network; United States; Remoto; USD 42.000 - 58.000; Tempo pieno

Descrizione del lavoro

Graham Healthcare Group seeks a Hospice Insurance Verification & Authorization Coordinator to support multiple service lines nationwide. The role ensures benefit information, patient liability, and authorizations are secured before care begins, coordinating with billing, scheduling, and clinical staff.

You will supervise the insurance verification team, monitor workflows, and maintain payer portals while guiding staff and handling escalations.

Competenze

• Knowledge of Insurance/verification of insurance.
• Excellent customer service.
• Detail oriented.
• Must demonstrate leadership abilities.
• Good organizational skills.
• Able to effectively manage concurrent demands and multi-task.
• Detail oriented.
• Effective verbal and written communication skills.
• Proficient in Microsoft Office suite.

Mansioni

• Interact with patient and patient’s family to coordinate the co-pays and deductibles for patients.
• Responsible for managing time off requests and timekeeping for insurance & authorization verification staff.
• Responsible for managing the insurance and authorization verification process.
• Daily review of problems related to all insurance changes.
• Daily/continuous monitoring of task flow screen related to all authorization issues including reauthorization needs and updating with actual authorizations.
• Assist scheduling with funding source problems related to scheduling 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.
• Think critically and act independently when resolving benefit discrepancies and escalate bad debt/write-offs when needed.
• Participate in interviews and assist in developing procedures to onboard new hires and retain current staff.
• Address timeliness and effectiveness of department activities based on reports and daily monitoring.
• Responsible for team members’ performance evaluation and disciplinary actions with supervisor oversight.
• Weekends, holidays and after hours based on business needs.

Conoscenze

Insurance verification

Authorization coordination

Customer service

Leadership abilities

Time management

Detail oriented

Microsoft Office

Formazione

Associate degree

Strumenti

Microsoft Office Suite

Descrizione del lavoro

Job Title
Hospice Insurance Verification & Authorization Coordinator

Location
Remote/Nationwide, USA

Additional Location(s)

Employee Type
Employee

Working Hours Per Week
40

Job Description

Summary

The Supervisor of Insurance Verification and Authorization is responsible for supporting the organization by ensuring that benefit information, authorization and patient liability are obtained prior to the clinical staff starting care for any Graham Healthcare Group Service Lines and branches. This position works closely under the guidance of either a Director or Manager and collaborates with several departments to ensure correct funding source information is updated in a timely fashion.

Essential Duties and Responsibilities

Include the following. Other duties may be assigned as necessary.

• - Responsible for all insurances accepted by the Agency.
• - Interact with patient and patient’s family to coordinate the co-pays and deductibles for patients.
• - Responsible for managing time off requests and timekeeping for insurance & authorization verification staff assigned.
• - Responsible for managing the insurance and authorization verification process.
• - Daily review of problems related to all insurance changes.
• - Daily/continuous monitoring of 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 call completed authorizations, obtain initial authorization, obtain reauthorization and update pending auth with actual auth info.
• - Assist scheduling with funding source problems related to scheduling 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.
• - Ability to think critically and act independently when resolving benefit discrepancies, along with escalating any bad debt/ write off concerns to supervisor.
• - Participate in interviews and assist in developing procedures with supervisor oversight to onboard new hire employees and retain current staff.
• - Address and maintain any timeliness and effectiveness of concerns of department activities based on reports and daily monitoring.
• - Responsible for team members’ performance evaluation and disciplinary actions with Supervisor oversight and approval.
• - Weekends, holidays and after hours based on business needs.
• - All other duties assigned by supervisor.

Qualification Requirements

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.

• - Must have knowledge of Insurance/verification of insurance.
• - Excellent customer service.
• - Detailed orientated.
• - Must demonstrate leadership abilities.
• - Good organizational skills.
• - Able to effectively manage concurrent demands and multi- task.
• - Detail orientated.
• - Effective verbal and written communication skills.
• - Proficient in Microsoft Office suite.

Education and/or Experience

• - Associate degree, preferred.
• - Minimum of one (1) year of experience in home care.
• - Minimum of one (1) year of experience in a customer service capacity.

Certificates, Licenses, Registrations

Must have and maintain in good standing professional license, certificate, or registration, as applicable.

Physical Demands

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.

Work Environment

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.

Comments

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.

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