Hospice Insurance Verification & Authorization Coordinator

Summary

The Supervisor of Insurance Verification and Authorization is responsible for supporting the organization by ensuring that benefit information, authorization and patient liability are obtained prior to the clinical staff starting care for any Graham Healthcare Group Service Lines and branches. This position works closely under the guidance of either a Director or Manager and collaborates with several departments to ensure correct funding source information is updated in a timely fashion.

Essential Duties and Responsibilities

Include the following. Other duties may be assigned as necessary.

• Responsible for all insurances accepted by the Agency.
• Interact with patient and patient’s family to coordinate the co-pays and deductibles for patients.
• Responsible for managing time off requests and timekeeping for insurance & authorization verification staff assigned.
• Responsible for managing the insurance and authorization verification process.
• Daily review of problems related to all insurance changes.
• Daily/continuous monitoring of task flow screen related to all authorization issues including but not limited to the following: determine if reauthorization needed for new orders, follow up on call completed authorizations, obtain initial authorization, obtain reauthorization and update pending auth with actual auth info.
• Assist scheduling with funding source problems related to scheduling visits to clinical staff.
• Assist billing department insurance verification discrepancies or authorization discrepancies which could hold up claim submission.
• Establish a thorough knowledge of all payer portals.
• Ability to think critically and act independently when resolving benefit discrepancies, along with escalating any bad debt/ write off concerns to supervisor.
• Participate in interviews and assist in developing procedures with supervisor oversight to onboard new hire employees and retain current staff.
• Address and maintain any timeliness and effectiveness of concerns of department activities based on reports and daily monitoring.
• Responsible for team members’ performance evaluation and disciplinary actions with Supervisor oversight and approval.
• Weekends, holidays and after hours based on business needs.
• All other duties assigned by supervisor.

Qualification Requirements

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Must have knowledge of Insurance/verification of insurance.
• Excellent customer service.
• Detailed orientated.
• Must demonstrate leadership abilities.
• Good organizational skills.
• Able to effectively manage concurrent demands and multi-task.
• Detail orientated.
• Effective verbal and written communication skills.
• Proficient in Microsoft Office suite.

Education and/or Experience

• Associate degree, preferred.
• Minimum of one (1) year of experience in home care.
• Minimum of one (1) year of experience in a customer service capacity.

Certificates, Licenses, Registrations

Must have and maintain in good standing professional license, certificate, or registration, as applicable.

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, climb stairs, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.