Insurance Eligibility Specialist

Brockton Home Health Care Agency is currently looking to hire an Insurance Eligibility Specialist to support our growth and provide top-notch customer service. This may be the position you have been looking for! Mon - Fri 9am to 5:30pm, some insurance knowledge is required.  Duties include verifying patients insurance, copays, checking patient balances, and checking if demographics or new insurance cards are required.

Job Responsibilities

·        Work with a team in a fast pasted environment to assist with onboarding new referrals coming from hospital, private practices, clinics, etc.

• Verifying all new patient referral’s insurance information (managed care, Commercial, Medicare, Medicaid, and other) and benefits to identify patient responsibility, authorization and coverage for Home Health and instantly communicate this information to the Intake team.
• Utilize online portals to identify plan benefits for Home Health.
• Re-verify patient accounts each week to ensure that active patients have accurate insurance information available for billing purposes and follow up with team lead scheduler, DON and administrator regarding the change.
• Enters new patient accounts into axxess accurately coding all required fields.
• Utilizes axxess to comprehensively document all information related to patient accounts to ensure that status of account is current. Provides feedback to team lead scheduler, DON and administrator as needed in areas that will maximize cash collection and minimize delays and unnecessary losses of revenue.
• Communicates with team lead scheduler, DON and administrator (via phone and e-mail) to review changes in services / patient status and completes edits and updates to billing account information as needed under the DON directions.
•  Call the Insurance provider to verify coverage, 2.notifies patients of changes in benefit levels and financial liability, if applicable. Follows up with DON and the DON will communicate with case managers and insurance providers accordingly and IES will put a communication note into the patient chart.
• Tracks and trends internal and external issues that are affecting the timely and accurate processing of patient referrals and maintenance of a complete patient accounting database using axxess. Reports any adverse trends to supervisor in a timely manner.
• Provide adequate follow up on accounts with any issues identified on claims/denials regarding current insurance status, i.e. coordination of benefits, termination of insurance, change of insurance, and communicate these issues to feedback to team lead scheduler, DON and administrator and the patient.
• Work daily reports that ensure account accuracy and smooth insurance billing process.

Required Qualifications / Skills

• Associates Degree in Business Administration preferred. Industry Certificates for job related topics are a plus.
• A minimum of 2 years’ experience in healthcare provider’s business office or hospital setting, proficient in patient registration, and verification of Third-Party Insurance benefits required.
• A working knowledge of government health insurance plan benefits and the rules & regulations for obtaining reimbursement preferred.
• Working knowledge of Home Health preferred.

Preferred Skills:

• Excellent communication (verbal and written) and interpersonal skills to interpret and explain policies, procedures, and third-party insurance benefits to patients and their families.
• Demonstrated ability to maintain confidentiality of patient information.
• Excellent organizational skills with attention to detail.
• Ability to work independently as well as part of a team.
• Demonstrated ability to identify research and problem solving.
• Ability to research and resolve problems independently.

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