Home Health Intake Specialist / Home Health Billing

Children's Nebraska•Omaha, NE

4h•Onsite

About The Position

At Children’s Nebraska, the mission is to improve the life of every child through exceptional care, advocacy, research and education. As the state’s only full-service pediatric healthcare center, they provide comprehensive, holistic care to patients and families—from primary and specialty care to behavioral health services. Dedicated to a People First culture, they foster an environment with joy, belonging, wellbeing, learning and growth. The Home Health Intake Specialist / Home Health Billing role involves receiving information for new or existing patients from referral sources or parent/caregivers. This includes completing insurance verification, authorizations, and patient registration. The specialist will proactively communicate with ordering providers and other CHHC departments to verify and coordinate the provision of clinically appropriate products for each patient. They will also create and manage delivery tickets and sales order templates for warehouse items, ensuring accurate data entry into the computer software system, and maintain DME product knowledge and understanding of different DME utilized for specific therapies.

Requirements

High School Diploma or GED equivalent
Minimum of 3 year experience in customer service setting, one of which can be experience working with insurance and/or revenue cycle related processes
Possess strong customer service skills.
Ability to communicate effectively both verbally and in writing.
The ability to use computers, fax machines and copiers.
Must have the ability to work independently to effectively and efficiently perform assigned duties.

Nice To Haves

Associate's Degree in Business, Finance, or related field
Experience with medical insurance plans and types of benefit coverage
Familiar with ICD-10, CPT and HCPC coding

Responsibilities

Receives information on new or existing patients with new service(s) from the referral source either by a phone call or faxed order.
Receives and enters orders in the computer software for supplies, and equipment pick up delivery tickets.
For each patient there is an insurance verification and eligibility check.
Ensure insurance eligibility check is documented.
Obtains verbal or written prior authorizations for all services in a timely manner and records the authorization in the computer software.
Notifies all parties involved of insurance coverage levels, or lack thereof.
Registers new patients in the computer system with complete and accurate information.
For each subsequent parent/caregiver contact verifies the patient address, phone number and insurance (eligibility check) with the parent/caregiver.
Daily multiple reviews all tasks, emails, faxes, and notes.
Reviews incoming faxes and completes physician orders, by generating sales orders and/or sales order templates and reviewing accurate product fulfillment.
Assigns the fax to the appropriate patient. As needed, completes steps for new patients or new service referrals.
Review assigned tasks, emails, and work queues daily and take steps to complete the tasks assigned, including identifying issues that can impact claims and routing to the appropriate department.
Contacts clinical departments for any needed information on new orders that are held in the Incomplete order list. If the order is pending a future start date, then the insurance verification, assessment for authorization may be completed prior to the start date.
Obtains the needed authorization at the beginning of service and reassesses the need for further authorizations at the end of the authorization.
Review new orders/referrals, including verifying insurance, completing an eligibility check, assessing insurance need for authorization for the requested service, updating sales order template to include new/updated order information such as order doctor and ICD-10 codes, and documenting this information into a patient note.
Review daily emails and take calls for patient/patient families ordering ongoing monthly supply order, this includes reviewing all patient demographics, updating insurance when applicable, checks eligibility, assesses need for authorization and obtains the needed supply list, prepare the sales order, update to the correct delivery method WIP state, document all changes and communications in a patient note.
Updates ICD-10 codes, demographics, and insurance information on patients as necessary.
Updates all sales order templates when necessary due to insurance change, this includes adding all items to be billed to insurance and updating price options.