Tyler, TX 75701
• Responsible for verifying private insurance eligibility and benefits on all new patients who have private insurance as a pay or source; ensure patient is not on service with another home healthcare agency providing same requested services & that requested services are covered benefits.
• Assists with monthly eligibility checks; notifies branches/billing/authorization coordinators of changes, including terminations, additional private insurance coverage and all needed follow up.
• Accurately and timely obtains pre-authorization of private insurance with submission of all required documentation.
• Provides timely notification to the appropriate office location and personnel responsible for scheduling care of new patient; fax and email Start of Care information and all other appropriate documentation on patient to correct office location.
• Serves as backup personnel for Financial Counselor as needed; answers all incoming calls, route calls to appropriate personnel, assist callers with information on home health services, documents patient referral information, and input referral information into computer system accurately.
• Act as a resource for nurse case managers, therapists and managers to provide information on referrals, agency services provided, and service areas.
• Responsible for accurate and timely processing of insurance verification; prioritize insurance verifications in order of urgency and Start of Care date.
• Requires ability to accurately type up to 50 wpm and exhibit excellent data entry skills.
• Excellent computer software skills necessary to produce accurate documents and materials required. Working knowledge of MS Office, Excel, or similar software required. Proficient use of MS Office and Excel preferred.
• 2-3 years of experience in calling insurance companies to obtain detailed benefit information and authorizations, customer service, electronic medical records maintenance, and basic spreadsheet skills.
• 2-3 years of experience in medical claims.
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