Insurance Verification and Authorization Specialist

Title: Insurance Authorization and Verification Specialist

Job Summary: The insurance authorization and verification specialist supports management by verifying initial and ongoing payer authorization and eligibility of home health services. The roles primary responsibility is to verify insurance benefits, obtain/maintain authorizations and enter into data base system. The ideal candidate will be an individual, who is just as comfortable working autonomously as with a team.

Duties and Responsibilities: • Verifies insurance eligibility an authorization of current and potential home health clients in an accurate and timely manner. • Communicates payer authorization and eligibility information to billing department and administrators • Enters insurance authorization and eligibility information • Notifies management regarding lack of payer coverage or other service non-coverage issues • Performs re-authorization and eligibility checks in a timely manner • Communicates and documents information regarding change in authorization and eligibility to management • Monitors and ensures all client authorization of services are current and quantity and type of services provided meet payer requirements • Reviews and ensures appropriate processing of authorizations • Sends informational correspondence to payer • Maintains professional, positive and effective communication with payer and clients • Maintains confidentiality of all information pertaining to clients • Performs other related duties and responsibilities as assigned • Maintains knowledge and education to remain current, efficient and productive as an authorization specialist • Demonstrates self-direction to prioritize and accomplish job responsibilities • Promotes agency philosophy and mission by presenting a positive image to patients, families, physicians and the overall community

Job Qualification and Experience:
• Minimum of two years of experience in insurance authorization, billing, business administration in health care and home care preferred
• Knowledge of third party payer regulations including Medicare, Medicaid, Veterans Affairs (VA) and private insurance
• Ability to promote and maintain a positive attitude and encourage others to do the same
• Strong organizational skills and the ability to work independently with minimal supervision
• Demonstrates ability to make appropriate judgments as it relates to payer authorization
• Strong written and oral communication skills. Basic computer skills with the ability to learn new software. Knowledge of Word and Excel a plus

Working Conditions and Physical Effort: Works in a routine office environment. The occasional need to lift, pull carry and push items up to fifty pounds. Frequent need to stoop, kneel and reach while accessing files. Requires working under some stressful conditions to meet deadlines. Requires typing and computer proficiency.

Job Type: Full-time

Pay: From $16.00 per hour

Expected hours: 40 per week

Benefits:
• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Vision insurance

Experience:
• Medical billing: 1 year (Preferred)
• Insurance verification: 1 year (Required)

Work Location: In person

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