Entry Level Insurance Admin

Hours: Monday through Friday from 8 AM to 4:30 PM is the main schedule, but candidates must be available to work the 10 AM to 6:30 PM shift occasionally.

Description:

• The Insurance and Authorization Specialist is an administrative support position that is considered the front line of the revenue cycle process when a patient requires care and they need to start the insurance verification process.
• The branches will put in orders for services, and this person obtains benefits and insurance information, part of the ongoing authorization process to update, tracking, and documentation of necessary tasks/updates to essentially get the patient coverage clearance for Home Call (LHC) home health services performed.
• 90% Back office high volume, fast-paced administrative tasks/ 10% phone calls to follow up or answer questions

Formal Overview:

• Obtains authorization from the payer’s case manager for services ordered/requested for prospects/ referrals promptly.
• Documents specific details related to the authorization, including effective and end dates, using the appropriate legacy system and associated software application via patient notes, authorizations, tasks, workflow, phone calls, and/or email.
• Obtains additional pre-certification as needed. Consults with the agency as needed for all private insurance referrals and documents/communicates via the software application promptly.
• Serves as a liaison between the branch location and the payer regularly.
• Coordinates and communicates with the branch location regarding any changes or updates from the payer promptly.
• Accesses authorizations via email, telephone, fax, and/or online application in the most efficient and timely manner.
• Resolves all customer requests, inquiries, and concerns expediently and respectfully.
• Problem solves independently before referring issues to the Supervisor/Manager for resolution.
• Performs eligibility and or similar, comparable, or related duties as may be required or assigned.

Additional Skills & Qualifications

• Open to candidates within retail, food industry, cashier, and strong customer service experience who can learn quickly.
• Consistent experience or ability to jump into a new environment, computer proficiency is extremely important!
• Open to ALL different experiences if comfortable with computers, most important is intangibles, customer service, dependable, willingness to learn, MUST PASS EXCEL Testing
• Best: customer service, medical, insurance