Specialist, Insurance

Lifepoint Health®; Vineland (NJ); Presencial; USD 48.000 - 64.000; Jornada completa

Descripción de la vacante

Lifepoint Health is seeking an Insurance Verification professional in Vineland, NJ to oversee all insurance-related processes for Community Healthcare System. You will verify benefits, check eligibility for Medicare and commercial payors, and support referrals to the host hospital.

Collaboration with clinical liaisons and program leaders is essential to ensure accurate insurance data. The role requires 2-5 years in post-acute healthcare insurance verification, with proficiency in Excel,

Formación

• Bachelor degree preferred.
• 2-5 years post-acute healthcare experience in Billing and/or Insurance Verification.
• Experience with Medicare, Medicaid and payor sources.

Responsabilidades

• Checks eligibility and verifies insurance information for Medicare and Commercial carriers.
• Utilizes Medicare Common Working File (CWF) to calculate Medicare Days.
• Uses payor websites and direct calls to check eligibility.
• Responds timely with financials and eligibility to Clinical Liaison and Program Director.
• Completes and files insurance verification forms with required data.

Conocimientos

Insurance verification

Data analysis

Excel

SharePoint

Educación

Bachelor Degree Preferred

Herramientas

Common Working File (CWF)

C-Snap

Excel

SharePoint

Kindred Applications

Descripción del empleo

Summary

Oversees all aspects of Insurance for the Community Healthcare System. Performs market-wide eligibility verification of benefits for potential Kindred customers. Performs re-verification for Medicare, Medicaid, and commercial insurance payor sources for referrals to the host hospital. Works closely with clinical liaisons, admissions, and Program Director to ensure proper insurance information has been obtained in order to facilitate Admissions. Maintains a current knowledge of Medicare and State Medicaid requirements and practices. Provides education and training for Clinical Liaisons with third party payors and insurance companies. Completes and compiles insurance reports for re-verification.

Qualifications

Education: Bachelor Degree Preferred

Experience

2-5 years Post-acute healthcare experience in Billing and/or Insurance Verification. At least one year using Database Administration, Common Working File and C-Snap.

Essential Functions

• Checks eligibility and verifies insurance information for Medicare and Commercial carriers.
• Utilizes Medicare Common Working File (CWF), to calculate Medicare Days.
• Utilizes payor online websites and direct phone contact to check eligibility.
• Responds timely with the financials and eligibility to the Clinical Liaison and Program Director.
• All financial forms must be legible and completed with all requested information as outlined on the Insuracne Verification forms.
• Performs data analysis which is often confidential in nature, to include the use of Excel, SharePoint and Kindred Applications.
• Maintains a current knowledge of modification to Medicare and state Medicaid plans as they impact Post Acute Care.
• Provides quarterly education to Clinical Liaisons and Program Directors on insurance changes and trends. Provides support and answers questions regarding anything related to insurance.
• Provides Ad-hoc tasks as requested by Program Director.
• Performs other duties as requested and required.
• Conducts job responsibilities in accordance with the standards set out in the Company's Code of Business Conduct, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards.

Company Overview

Lifepoint Health is a leader in community-based care and driven by a mission of Making Communities Healthier. Our diversified healthcare delivery network spans 29 states and includes 63 community hospital campuses, 32 rehabilitation and behavioral health hospitals, and more than 170 additional sites of care across the healthcare continuum, such as acute rehabilitation units, outpatient centers and post-acute care facilities. We believe that success is achieved through talented people. We want to create places where employees want to work, with opportunities to pursue meaningful and satisfying careers that truly make a difference in communities across the country.