High school or equivalent (Preferred)
Insurance verification: 1 year (Preferred)
Medical billing: 1 year (Preferred)
Memorial Care Home Health is looking for an Insurance Verification Clerk to join our dynamic Team.
The position is in the Intake Department and will verify insurance and benefits for all patient referrals.
Job Summary:
Primary responsibility is to obtain insurance authorization for home health care services for new patients in accordance with their third-party payer policies while following all federal, state, and local regulations including Medicare and Medi-Cal guidelines. This position works closely with several departments to ensure correct funding source information is updated and tracking managed care cases to assure maximum reimbursement. This position demonstrates patience, flexibility and a cooperative attitude.
Job Qualifications:
Education:
High school graduate required,
Associates Degree or related medical business courses (preferred.)
Experience:
One or more years of insurance authorization experience preferred.
Prior experience in home health preferred.
Skills:
Proficient in Microsoft Office, knowledge of Medicare My Ability/IVAN portal software preferred. Knowledge of Monarch Practice Connect. Knowledge of private insurances (i.e. Blue Cross, United HealthCare, Cigna, Aetna). Individual must have effective verbal and written communication skills with external and internal customers. Individual must be detail-oriented, be able to prioritize tasks, and have excellent time management skills.
Transportation:
Reliable transportation. Valid identification.
Essential Job Requirements:
· Obtain authorization and reauthorization for home health care services for new and existing patients whose insurance requires authorization for services.
· Obtain re-authorization for home health care services for existing patients as their authorization expires.
· Track authorizations for patients whose health care insurance requires authorization.
· Communicate with field staff case manager and scheduling regarding authorization obtained, amounts, date ranges, and limits.
· Communicates with Clinical Manager for difficulties obtaining insurance authorization.
· Obtain retro-authorizations as needed.
· Functions within the job description of his/her position.
· Reports to work promptly and without absences.
· Other tasks as determined to be necessary by management.
· Demonstrates problem solving skills.
· Supports Memorial Care Home Health services mission statement, philosophies, and objectives promoting safe delivery of home health care services.
· Maintains a professional appearance and a business-like attitude.
· Functions within the job description of his/her position.
· Complies with agency policies set forth in the Code of Conduct and Employee Handbook.
Environmental and Working Conditions:
Works in a routine office environment. Noise level may be moderately high, ability to work a flexible schedule and extended hours if needed. Possible exposure to toxic materials such as toner, etc.
Physical and Mental Effort:
Prolonged sitting and some standing required. Occasional need to lift, pull, carry, and push items weighing up to 50 lbs. Frequent needs to stoop, kneel, and reach while accessing files. Requires working under some stressful conditions to meet deadlines and agency needs. Requires hand-eye coordination and manual dexterity. Requires excellent problem-solving skills.
About Us:
Memorial Care Home Health serves all of Orange County. We believe that a healthy, growing organization, where team members have true opportunities to thrive, leads to healthier outcomes for our patients and employees. We're building a company culture that embraces the values of respect, accountability, communication, teamwork, integrity, positive attitude, continuous improvement and employee appreciation.
Fulltime Position
Job Type: Full-time
Pay: $15.00 - $19.00 per hour
Benefits:
Schedule:
Education:
Experience:
Work Location: One location
