Home Health Intake Specialist / Home Health Billing

Children's Hospital & Medical Center•Omaha, NE

16h•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 and everything in between. 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, 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. Responsibilities also include creating and managing delivery tickets and sales order templates for warehouse items, ensuring accurate data entry, and maintaining DME product knowledge.

Requirements

High School Diploma or GED equivalent
Minimum of 3 years experience in a customer service setting
One year of experience working with insurance and/or revenue cycle related processes
Possess strong customer service skills
Ability to communicate effectively both verbally and in writing
Ability to use computers, fax machines and copiers
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

Receive information on new or existing patients with new service(s) from the referral source either by a phone call or faxed order.
Receive and enter orders in the computer software for supplies, and equipment pick up delivery tickets.
Perform insurance verification and eligibility checks for each patient.
Ensure insurance eligibility checks are documented.
Obtain verbal or written prior authorizations for all services in a timely manner and record the authorization in the computer software.
Notify all parties involved of insurance coverage levels, or lack thereof.
Register new patients in the computer system with complete and accurate information.
For each subsequent parent/caregiver contact, verify the patient address, phone number and insurance (eligibility check).
Daily review all tasks, emails, faxes, and notes.
Review incoming faxes, complete physician orders by generating sales orders and/or sales order templates, review accurate product fulfillment, and assign faxes to the appropriate patient.
Review assigned tasks, emails, and work queues daily, completing tasks and identifying issues that can impact claims.
Contact clinical departments for any needed information on new orders held in the Incomplete order list.
Obtain needed authorization at the beginning of service and reassess the need for further authorizations at the end of the authorization period.
Review new orders/referrals, including verifying insurance, completing an eligibility check, assessing insurance need for authorization, updating sales order templates with new/updated order information (e.g., order doctor and ICD-10 codes), and documenting information in a patient note.
Review daily emails and take calls for patient/patient families ordering ongoing monthly supply orders, including reviewing patient demographics, updating insurance, checking eligibility, assessing authorization needs, obtaining supply lists, preparing sales orders, updating delivery methods, and documenting communications.
Update ICD-10 codes, demographics, and insurance information on patients as necessary.
Update all sales order templates when necessary due to insurance changes, including adding items to be billed to insurance and updating price options.
Communicate proactively with ordering provider and other CHHC departments to verify and coordinate the provision of clinically appropriate products for each patient.
Create and manage delivery tickets and sales order templates for warehouse items, ensuring accurate data entry into the computer software system.
Maintain DME product knowledge and understanding of different DME utilized for specific therapies.