Insurance Verification & Authorization Representative - Home Health

Lehigh Valley Hospital, Inc.; Allentown, Northern (Lehigh County, KY); Hybrid; USD 42,000 - 58,000; Full time

Job summary

Lehigh Valley Hospital, Inc. is seeking an Insurance Verification and Authorization Representative for Home Health to verify coverage and obtain authorizations for services.

You will document deductible, co-pay, and coinsurance information and input accurate data into case notes for clinicians. You will coordinate appeal processes for denied payments and assist in meeting deadlines.

Strong computer skills and a customer-focused approach are required; associate degree is preferred.

Qualifications

• High School Diploma or GED required.
• Excellent computer skills.
• Demonstrated flexibility and problem solving.
• Customer service oriented.

Responsibilities

• Obtain authorization for home health and hospice services.
• Document insurance requirements and patient financial responsibilities.
• Coordinate appeal processes for denied payments.
• Enter insurance information into case notes for clinicians.
• Support clinicians with insurance verification and authorization issues.

Skills

Excellent computer skills

Problem solving

Customer service

Education

High School Diploma/GED

Associate’s Degree

Job description

LV HOME CARE AND HOSPICEINSURANCE VERIFICATION AND AUTHORIZATION REPRESENTATIVE - HOME HEALTH FULL TIME DAYS**Summary** Obtains and monitors insurance authorization for home health and hospice patients. **Job Duties*** Obtains authorization for all services based on insurance to ensure database integrity and facilitate claims processing.* Documents patient authorization requirements, deductibles, co-payments, and coinsurance responsibilities. Completes accurate and complete insurance information into case communication notes for clinicians.* Coordinates appeal processes for denied payment due to authorization or other insurance complications.* Writes and submits appeals with substantiating documentation within deadline restrictions.* Follows computer system, department operational procedures, and training guidelines to obtain accurate insurance information.* Functions as a resource regarding insurance verification and authorization issues.**Minimum Qualifications*** High School Diploma/GED* Demonstrated flexibility and effective problem solving in accommodating and meeting customer needs.* Excellent computer skills.**Preferred Qualifications*** Associate’s Degree* Less than 1 year Healthcare office setting or* Less than 1 year Authorization**Physical Demands** Lift and carry 25 lbs. frequent sitting/standing, frequent keyboard use, \\*patient care providers may be required to perform activities specific to their role including kneeling, bending, squatting and performing CPR. Job Description Disclaimer: This position description provides the major duties/responsibilities, requirements and working conditions for the position. It is intended to be an accurate reflection of the current position, however management reserves the right to revise or change as necessary to meet organizational needs. Other responsibilities may be assigned when circumstances require.