Hospice Insurance Verification & Authorization Coordinator

Graham Healthcare Group • Virtual MI, MI

5d • $20 - $23 • Remote

About The Position

The Hospice Insurance Verification & Authorization Coordinator obtains benefit information, authorizations, and patient liability information before clinical staff begin care across service lines and branches. The role works with other departments to ensure accurate funding-source information is updated promptly. Daily work is driven by assigned workflows in the Homecare Homebase (HCHB) electronic medical record. HCHB experience is required.

The position is remote nationwide, but candidates must live in the Eastern or Central time zone. The schedule is Monday through Friday, 9:30 a.m. to 6 p.m., with availability to work every other Saturday. The position pays $20.00–$23.00 per hour; the stated compensation range has a maximum cap of $23.00.

The role generally operates in a clerical office setting and routinely uses computers, phones, photocopiers, filing cabinets, and fax machines. Travel by automobile may occur, and the employee may be exposed to changing weather conditions. The position includes physical demands such as regularly talking or hearing, standing, walking, sitting, climbing stairs, handling objects or controls, and reaching; frequent lifting or moving of up to 20 pounds is also required.

Graham Healthcare Group describes itself as an innovator in healthcare business and technology solutions, with more than 20 years of experience supporting its home health and hospice companies and integrating solutions across the healthcare continuum.

Requirements

• Homecare Homebase (HCHB) experience is required.
• At least one year of prior experience in insurance verification, authorization, or medical billing.
• Proficiency in Microsoft Office Suite.
• Knowledge of Medicare, Medicaid, third-party insurance, and authorization requirements.
• Knowledge of insurance websites.
• Conscientiousness and attention to detail.
• Patience, flexibility, and a cooperative attitude.
• Ability to think critically and act independently when resolving benefit discrepancies.
• Effective verbal and written communication skills with internal and external contacts.
• Ability to work independently and as part of a multidisciplinary team.
• Availability to work weekends, holidays, and after hours based on business needs.
• Must live in the Eastern or Central time zone.
• Must be willing to work every other Saturday.
• Must have and maintain in good standing a professional license, certificate, or registration, as applicable.

Nice To Haves

• Associate degree or a combination of experience and business courses.
• Knowledge of Homecare Homebase.

Responsibilities

• Obtain detailed and accurate insurance benefit information using payer portals, phone, or fax.
• Validate and document payer information, including patient name, date of birth, and policy number, in the EMR.
• Document deductibles, copayments, coinsurance, and out-of-pocket maximums in patient charts through coordination notes to help reduce write-offs.
• Monitor HCHB task flows for insurance issues, including Medicare eligibility, completed on-call insurance tasks, verification, eligibility alerts, initial authorization, recertification, and resumption of care.
• Review entitlement verification reports daily and research questionable results.
• Review insurance-change issues and funding-source update issues daily.
• Reverify current Medicaid patients monthly to monitor HMO status, and reverify current patients’ insurance monthly to identify payer changes or other agencies.
• Contact patients, hospitals, or physician offices to obtain information or clarify benefits.
• Assist scheduling with funding-source problems affecting visits scheduled for clinical staff.
• Coordinate with clinical staff to ensure agency/provider-of-choice transfer forms are received and sent to another agency within appropriate timeframes.
• Obtain initial, prior, and ongoing authorizations required by insurers through phone, fax, or payer portals.
• Maintain the authorization tab in HCHB.
• Provide clinical information requested by insurance companies.
• Follow up with insurers about authorization submissions and requests for additional clinical information, and notify internal clinical staff of approvals and denials.
• Monitor HCHB task flows for authorization issues, including reauthorization needs for new orders, on-call authorization follow-up, initial authorizations, reauthorizations, and updating pending authorizations with actual authorization information.
• Assist the billing department with insurance-verification or authorization discrepancies that could delay claim submission.
• Develop and maintain thorough knowledge of payer portals.
• Comply with the company’s Core Values and Core Competencies.
• Perform other duties as assigned.

Benefits

• Medical, dental, and vision insurance options for employees and their families.
• 401(k) plan and pension; the job details specify a 4% employer contribution.
• 15 days of PTO, with the company also describing its PTO packages as generous.
• Company-paid life insurance and disability benefits.
• Pre-tax FSA and HSA plans.
• Company-paid education programs, including 50% tuition discounts for selected Purdue and Kaplan courses.
• Competitive pay with opportunity for advancement.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: No Education Listed