Reimbursement Coordinator-E&A

About the Role

Performs designated intake, insurance verification, eligibility review, authorization submission, review, and follow-up. Works directly with payors and internal and external customers to achieve efficient and effective insurance and authorization outcomes.

Responsibilities

• Coordinates intake, insurance, and authorization activities for designated accounts to ensure timely and accurate verification of coverage, benefits, authorization submission, and follow-up.
• Determines and initiates appropriate action to review and verify insurance reports for patient eligibility, benefits, limitations, coordination of benefits, plan coverage, and patient liability.
• Reviews referral documents from outside or internal sources to obtain required information and accurately completes data entry of patient information into the EMR system within expected time frames.
• Verifies prior authorization and/or pre-service requirements as determined by payor, submits authorization requests via the preferred method, combines required documents for submission, and enters authorization details accurately into the patient chart within the EMR.
• Completes follow-up of submissions to ensure process completion and assists with authorization denials when applicable.
• Prepares special handling and/or processing for payors and/or clients.
• Performs other job duties as assigned.

Requirements

• GED or High School Diploma.
• At least 1-2 years of relevant work experience.
• Insurance and authorization experience in the healthcare industry.
• Home Health and Hospice insurance and authorization experience.

Job Expectations

• Willing to work additional or irregular hours as needed.
• Must work in accordance with applicable security policies and procedures to safeguard company and client information.
• Must be able to sit and view a computer screen for extended periods of time.

Benefits

• Excellent medical with Rx, dental, and vision benefits.
• Mental health support through EAP.
• Generous paid time off, plus 13 paid holidays.
• 100% vested 401(K) retirement plans.
• Educational assistance up to $2500 per year.