Auto Claims Adjuster
Sedgwick
Lead Intake and Insurance Verification Coordinator
Centene Corporation
full-time
Posted on:
Location Type: Remote
Location: Remote • Florida • 🇺🇸 United States
Visit company websiteSalary
💰 $19 - $32 per hour
Job Level
Senior
About the role
- Obtain and verify complete insurance information, including the prior authorization process, copay assistance and coordination of benefits
- Assist with managing the work load to ensure that referrals and orders are handled in a timely manner
- Monitor each queue through various reports and redistribute work as appropriate
- Serve as the point of contact for key physicians’ offices and coordinate referrals with the sales team during insurance verification process
- Serve as the point of contact or designated rep for contracted payors
- Serve as the point of contact or designated rep for special pharma accounts working with their HUB’s and collecting and documenting pharma
- specific data in the system
- Obtain and verify insurance eligibility for services provided and document complete information in system
- Perform prior authorizations as required by payor source, including procurement of needed documentation by collaborating with physician offices and insurance companies
- Collect any clinical information such as lab values, diagnosis codes, etc.
- Determine patient’s financial responsibilities as stated by insurance
- Configure coordination of benefits information on every referral
- Ensure assignment of benefits are obtained and on file for Medicare claims
- Bill insurance companies for therapies provided
- Document all pertinent communication with patient, physician, insurance company as it may relate to collection procedures
- Identify and coordinate patient resources as it pertains to reimbursement, such as copay cards, third party assistance programs, and manufacturer assistance programs
- Handle inbound calls from patients, physician offices, and/or insurance companies
- Performs other duties as assigned
- Complies with all policies and standards
Requirements
- High school diploma or equivalent
- 3+ years of medical billing, insurance verification experience, call center, and/or previous experience as a lead managing cross functional teams required
- Experience with payors and prior authorization requirements
Benefits
- competitive pay
- health insurance
- 401K and stock purchase plans
- tuition reimbursement
- paid time off plus holidays
- flexible approach to work with remote, hybrid, field or office work schedules
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
medical billinginsurance verificationprior authorizationdocumentationbillingcoordination of benefitsfinancial responsibility determinationclinical information collectioncopay assistancethird party assistance programs
Soft skills
communicationteam managementorganizational skillscollaborationproblem-solvingtime managementcustomer serviceattention to detailadaptabilityleadership
Certifications
high school diploma or equivalent
