Authorization & Eligibility Coordinator – Healthcare/SaaS/EHR
Raintree Systems
full-time
Posted on:
Location Type: Remote
Location: Alabama • Arizona • United States
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About the role
- Ensure quality and timely benefit/eligibility verifications along with the management of client enrollment and credentialing for multi-specialty medical professional services
- Responsible for the verification and eligibility of patient health insurance benefits via external insurance web portals or over the phone
- Responsible for authorization submission as needed based on patient's health insurance requirements
- Assures all insurance information has been completely and accurately obtained
- Documents all pertinent insurance eligibility information
- Documents information given or received to support actions taken on insurance issues
- Assures all authorization information is documented completely and accurately for claims processing
- Review, evaluate and assist in creating processes and workflows for future benefit and authorization teams
- Monitor authorization exceptions to ensure timely claim billing
- Communicate with clients regarding authorization or eligibility issues or trends
- Assist external departmental personnel in strategically critical issues as the need arises
Requirements
- High School Diploma, GED, or equivalent work experience
- Requires consistent judgment using software and industry expertise to analyze client needs and processes and then exercise discretion regarding how to configure and customize the solution
- Ability to teach end users in the solution's optimal use
- Requires knowledge of multiple medical specialties and the rules regarding their billing and documentation
- Understanding of accounting principles governing corporate reporting, teaching - including developing custom training plans and documentation
- Understanding of software engineering / development processes
- Well-developed verbal, listening and phone communication skills
- Good written communication skills with the ability to write routine correspondence
- Ability to add, subtract, multiply, and divide in all units of measure
- Ability to define problems, collect data, establish facts, and identify trends
- Strong organizational skills and ability to execute manual detailed tasks
- Strong customer service focus and commitment
- Ability to establish and maintain effective working relationships within the team
- Ability to work well with diverse personalities
- Tactful, mature and flexible
- Ability to work remotely
- Strong video conferencing etiquette
Benefits
- Remote Work/Work From Home
- Paid Time Off/11 Paid Holidays/Year-End Holiday Break
- Health, Dental, Vision, HSA/FSA
- 401K with Company Match
- Disability & Life Insurance
- Employee Assistance Program
- Paid Parental Leave
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
benefit verificationeligibility verificationauthorization submissioninsurance documentationclaims processingbilling rulesaccounting principlessoftware engineeringdata analysiscustom training development
Soft skills
communication skillsorganizational skillscustomer service focusproblem-solvingteam collaborationflexibilitytactfulnessteaching abilityattention to detailremote work capability
Certifications
High School DiplomaGED