- Professional
- Bureau à Arlington
TITLE: Insurance Coordinator
REPORTS TO: Manager, Intake
EMPLOYMENT STATUS: Fulltime
JOB SUMMARY:
Ensures that the patients' insurance covers treatment. Initiates and secures authorizations, pre-certifications, and/or predeterminations. Has excellent interpersonal skills and can successfully communicate with referral sources, sales staff, insurance carriers and operations team.
REQUIREMENTS
- Education:
- High School Diploma or Equivalent
- Experience:
- 2 to 4 years experience in insurance reimbursement
- 1 to 2 years experience in home care/home infusion reimbursement.
- A strong understanding of the different types of insurance plans
- Good communication skills, organizational skills and self-motivated worker.
- Computer literate.
- Fulltime Employment:
- 40hrs per week. Work week is Monday thru Friday.
- Schedule determined by supervisor.
JOB RESPONSIBILITIES
- Contact the patient’s insurance carrier to verify coverage for prescribed therapy.
- Obtain authorization for services from the patient’s insurance carrier.
- Communicate with the pharmacy, nursing department, and billing departments regarding the patient’s insurance benefits. Submit insurance verification form and authorizations.
- Participate in patient rounds daily to determine the ongoing care needs of the patients.
- Track authorizations and obtain reauthorizations as needed.
- Obtain necessary clinical documentation and/or physician’s letter of medical necessity as required by the patient’s insurance carrier.
- Complete data entry in Specialty Pharmacy Business Operating system.
- Prepare patient start of care documentation.
- Financial counsel patient and/or patient representative.
- Assist in upfront collection of patient balances, deductibles, and coinsurance amounts.
- Electronic storage of all patient information including e-mails in Electronic Document Management system.
- Assist in any other project given by Intake Manager & Senior Management.
