Insurance Specialist – Must live in Texas

Job Description

JOB TITLE: Insurance Specialist

REPORTS TO: Director of Billing and Authorizations

JOB OVERVIEW: Insurance Specialist is a qualified individual who will perform a variety of administrative functions related to quote of benefits and coordination with the parent, Patient Services Specialists and Authorizations team, in the corporate office of a Home Health Care Agency.

ESSENTIAL FUNCTIONS INCLUDE BUT ARE NOT LIMITED TO:
• Knowledgeable about specific payers and processes efits in a skilled and timely manner.
• Knowledgeable about specific payers and processes
• Self–Directed; needs minimal supervision
• Maintains a positive and professional attitude at all times.
• Demonstrates excellent customer service skills with both internal and external customers
• Exhibits excellent communication skills. Is able to clearly and concisely explain complex information.
• Solutions oriented
• Verifies patient insurance eligibility and benefits. May assist in obtaining and managing Insurance AUTHORIZATIONS, as needed.
• Contacts parent/Caregiver to discuss QOB, financial responsibility and payment options
• Uses multiple computer applications to manage and maintain medical records, verify insurance eligibility and communicate with patient caregivers as well as other teams within the agency.
• Scans documents into the electronic medical record as necessary.
• Works independently to identify appropriate next steps following communication with caregiver.
• Demonstrate Critical Thinking and Problem Solving related to coordinating Insurance Criteria and Division Criteria for patient admissions and communications.
• Maintain a clean and organized office environment at all times.
• Be flexible and able to perform a wide variety of administrative support functions as directed
• Performs all duties in compliance with agency policies and procedures.
• High School graduate, some college course work-preferred.
• Ability to multi-task with above average organizational skills-required.
• Excellent administrative, organizational, and phone skills-required.
• Strong Working knowledge of MS Word, MS Excel, and Outlook-required.
• Experience in medical insurance, intake department, or authorizations, in-take department, or doctor’s office-preferred.