Verification Specialist

Alternate Solutions Health Network; Kettering (OH); Remote; USD 19,000 - 28,000; Full time

Benefits offered by this job

Medical, dental, and vision insurance

Paid time off and 401K with match

Life and disability insurance

Employee Assistance Program

Job summary

Alternate Solutions Health Network is hiring a Verification Specialist to review patient eligibility for home health services and keep patients and parties informed throughout the verification process. This role requires local proximity to Kettering, OH, with a schedule that includes weekend days and on-call rotation.

You will complete data entry for new patient referrals, verify insurance coverage, and coordinate with hospitals as needed, ensuring accurate information and smooth billing

Qualifications

• High-School graduate or equivalent.
• 2 years of experience in the insurance verification/healthcare field.
• Knowledge of CMS guidelines and familiarity with medical terminology.
• Capable of all physical demands.

Responsibilities

• Customer Service: communicate with patients and families about insurance verification and billing; explain services covered and out-of-pocket costs.
• Operations: verify patient eligibility for services; confirm Face-to-Face Encounter with physician; manage hospital hold workflow.
• Policies: follow CMS guidelines; complete required documentation per company requirements.
• Teamwork: keep staff updated throughout process.

Skills

Insurance verification

Communication skills

Attention to detail

Problem solving

MS Office

Education

High-School diploma or equivalent

Tools

Microsoft Office

Job description

Our culture and people are what set us apart from other post-acute care providers. We’re dedicated to the growth and development of our team to set them up for success. We CARE for our patients like they are our own FAMILY.

Must be local to Kettering, OH

Schedule

Sunday, Monday, Thursday, & Friday 8:00am - 6:30pm with on-call & holiday rotation

Compensation

Starting at $17.00 an Hour!

Location

Fully Remote

How You'll Make a Difference

At Alternate Solutions Health Network, we care for patients where they spend the majority of their time – in their homes. Today we care for patients who need skilled home care and hospice services. You won’t find our brand in many places because we partner with health systems, jointly running home health and hospice agencies that use their brand. This is part of our strategy. By being part of the health system team, we can ensure each patient has a well-coordinated care plan that remains consistent whether the patient is seeing their primary care physician, receiving treatment in a hospital, or under our care in the home. As a Verification Specialist, you will examine patient eligibility to receive home care services and keep the patient and necessary parties are well informed throughout the verification process.

What We Offer

• We provide medical, dental, and vision insurance with flexibility for you to select what works best for you.
• Eligible teammates receive paid time off and may participate in the 401K, if they choose.
• Historically the company has matched 401K contributions which helps build your nest egg even faster.
• Finally, our benefit program includes company paid life, disability insurance, and a robust Employee Assistance Program.

How You'll Work

You’ll complete data entry for new patient referrals and investigate the type and level of insurance coverage.

Major Areas Of Responsibility

• Customer Service: Communicates with the patients and their family regarding the insurance verification and billing process. Ensures a clear understanding of the services covered by the insurance companies and the out of pocket costs to be relayed to the patient. Contacts insurance companies to verify patient information and coverage as needed.
• Operations: Evaluate patient eligibility to receive ordered services. Verify Face-to-Face Encounter with physician for billing requirements. Complete hospital hold workflow which may include faxing summary to hospital and following up on hospitalized patients.
• Policies: Understand and practice agency policies and procedures and stays current with CMS guidelines. Perform workflow and data reporting in accordance with CMS guidelines. Complete and submit all required documentation within specified company requirements.
• Teamwork: Up-date appropriate staff throughout process.

Hard & Soft Skills

• Compassionate communicator with a positive attitude.
• Patience is a virtue when working with patients, families, physicians, and coworkers.
• Attention to detail is critical, as is being observant and following directions.
• Problem solving and create solutions to drive to a course of action.
• Technological skills to include the ability to research equipment online, comfortable learning new software and database systems and the ability to use Microsoft Office.

Requirements

• High-School graduate or equivalent.
• 2 years of experience in the insurance verification/healthcare field.
• Knowledge of CMS guidelines and familiarity with medical terminology.
• Capable of all physical demands.

This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee. Duties, responsibilities and activities may change or new ones may be assigned at any time with or without notice.

We are an Equal Opportunity Employer.