The Insurance/Authorization Verification Coordinator is responsible for tracking and obtaining all insurance authorizations from insurance carriers. Experience with electronic medical records and knowledge of medical terminology is required. Customer service abilities, including strong writing and verbal skills, are essential.
Performance Responsibilities and Standards:
1. Perform insurance verification within 24 hours of receipt of referral for services and document coverage details thoroughly in an accurate and timely fashion.
2. Obtain initial authorization for service as necessary.
3. Performs re-authorizations, electronic eligibility confirmation and document results.
4. Work with insurance companies and clinical teams to obtain timely authorization for ongoing services.
5. Act as a resource person for staff and/or clients regarding questions on insurance coverage.
6. Utilize software system and insurance website to obtain then note accounts appropriately and document information in the Medical Record.
Requirements:
1. Understand and adhere to agency policies and procedures.
a. Maintain client confidentiality
b. Demonstrate knowledge and compliance with agency policies, procedures and keys to quality care.
c. Demonstrate knowledge of agency quality improvement standards.
d. Maintain an organized work area.
e. Complete all work accurately and timely.
2. Expectations.
a. Provide excellent customer service.
b. Responsible for personal growth and development.
c. Maintain positive working relationships with co-workers.
d. Perform other job-related duties as directed.
e. Practice and adhere to the "Code of Conduct" philosophy and "Mission and Value Statement"
Job Qualifications:
1. Knowledge of third-party payers; 1 year experience in insurance authorizations is preferred
2. High school diploma; Associate's degree preferred in related field.
4. Excellent organizational skills, ability to prioritize multiple tasks and responsibilities.
5. Flexible and able to work in a changing environment.
6. Ability to work in a fast-paced environment.
7. Be able to utilize and navigate insurance websites efficiently
8. Excellent customer service, communication and interpersonal skills.
Physical Requirements:
1. Ability to sit or stand approximately 90% of the day.
2. Visual ability sufficient to read forms, documents and computer screen.
3. Ability to communicate on the telephone.
4. Attention to detail
5. Utilize computer, phone and fax in a consistent manner
6. Bloodborne Pathogens Exposure Determination Category: Category III- Employee who rarely has contact with blood and body fluids.
Compensation & Benefits:
Competitive Salary [This position is an H06 non-exempt position with a min-max rate of: $19.96-$24.96/hour] with:
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About Nascentia Health:
Nascentia Health is leading the way in home care, post acute care and long-term community health. A healthcare system without walls, Nascentia is an innovator in the concept of healthcare, truly focused on the patient as a whole. By serving people in their homes, Nascentia Health is able to provide true holistic care. We can address immediate needs, help support positive long term medical and lifestyle choices that provide for better outcomes, leverage cutting edge in-home care technologies, and help avoid unnecessary visits to busy healthcare facilities.
Our employees are our greatest asset. They work hard every day to make our system amazing and are dedicated to our mission of being the premier home and community-based care system for the regions we serve. We want everyone to love what they do, be excited about coming to work, and take pride in being part of our team.
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Nascentia Health is an Equal Opportunity Employer (EOE)
Employment is contingent upon negative results of a pre-hire drug screen and background check clearance
Nascentia Health has more than 130 years of healthcare experience in Upstate New York. Our goal is to make it as simple as possible for people to receive all the care they need, where they want it most—in their own homes. As one of the area's premier home and community-based care systems, we offer specialized services ranging from skilled nursing to home health aides to ensure our clients get exactly the level of service they need to stay independent and healthy at home.
Nascentia also offers insurance plans for individuals eligible for both Medicare and Medicaid, including:
• Nascentia Health Plus – Medicare Dual Advantage Special Needs Plan (D-SNP) and Nascentia Skilled Nursing Facility Plan (I-SNP)
• Nascentia Health Options – a Managed Long Term Care (MLTC) Medicaid Plan for those eligible for a nursing home level of care
Nascentia is an innovator in the concept of healthcare, truly focused on the patient as a whole. We are a healthcare system dedicated to providing healthcare the right way, leveraging leading in-home care approaches and technologies to improve outcomes and improve quality of life.
At the heart of Nascentia are the people who make the healthcare system what it is and who make positive results possible. We take pride in our work and in helping the people we serve. We have the ambition and drive to be the best at what we do, we possess strong core competencies in our specialties and we work together to manage care effectively. We promise to bring all our resources, knowledge and energy to our patients and their families.
