Home Health Insurance Authorization Specialist
CenterWell Senior Primary Care
full-time
Posted on:
Location Type: Remote
Location: United States
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Salary
💰 $43,000 - $56,200 per year
Job Level
About the role
- Daily audit of admission, discharge and other source documentation to ensure revenue is recognized appropriately and all conditions of payment are met.
- Verify patient eligibility and payor coverage guidelines to ensure that all necessary information is secured for timely, accurate revenue recognition.
- Weekly generation of site revenue and resolution of batch errors and bill holds as appropriate.
- Weekly communication with site leadership detailing outstanding documentation or other issues resulting in a potential loss of revenue.
- Prepare and submit invoices to Accounts Payable for reimbursement and performs follow up to ensure accurate, timely payments are made to our facility partners.
- Prepare, submit and follow up on authorization and re-authorization requests according to applicable state and commercial payor guidelines.
- Coordinate, review, and analyze documentation and data entry supporting Medicare, Medicaid, and commercial payer requirements to ensure accurate and timely billing.
- Ensure all internal controls and related policies/procedures are implemented and followed in accordance to the accounts receivable requirements.
- Ensure all payer requirements are met accordingly, including pre-cert requirements, notification requirements, and level of care change required documents.
- Alerts appropriate team members at the Site regarding late or missing documents required for billing.
- Establish and maintain positive working relationships with Sites, Nursing Home Facilities, and AR Teams.
- Maintain the confidentiality of patient/client and agency information.
- Maintain accurate and up to date information for all vendor and nursing facility contracts.
- Keep information in an orderly manner readily accessible for review.
- Presents status as requested.
- Assure for compliance with local, state and federal laws, Medicare regulations, and established company policies and procedures.
- Participate in special projects and performs other duties as assigned.
- Assist with training of newly-hired associates, as well as re-education of revenue teams as necessary.
- Act as an information resource for any hard revenue generation issues or system issues. Basically the subject matter expert.
Requirements
- One or more years of related experience and/or training preferred.
- Two or more years of Home Healthcare or Medical Office experience preferred.
- Knowledge of insurance reimbursement and authorization process preferred.
- Proficient in using computers and Microsoft Office applications, including Word, Excel, and Outlook.
- Two years college preferred.
Benefits
- medical, dental and vision benefits
- 401(k) retirement savings plan
- time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave)
- short-term and long-term disability
- life insurance
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
revenue recognitionbillingdata entrydocumentation analysisauthorization processinsurance reimbursementaccounts receivableinternal controlscompliancepatient eligibility verification
Soft Skills
communicationrelationship buildingorganizationtrainingproblem-solvingattention to detailconfidentialityteam collaborationadaptabilityleadership