Insurance Authorization Specialist | Horizon Home Health and Hospice |Emmett, ID

Horizon Home Health and Hospice•Emmett, ID

10h

About The Position

LOVE WHERE YOU WORK!!! Horizon is one of Idaho's oldest and largest Home Health agencies. We have been in business for over 20 years and currently have branches from Fruitland to Meridian. We pride ourselves on our quality of care and ethical business practices as well as our foundational Core Values CAPLICO- - -Celebrate, Accountability, Passion for Learning, Intelligent Risk Taking, Customer Second, and Ownership. How we do it: CELEBRATING successes large or small. We hold each other ACCOUNTABLE with respect and professionalism. Our PASSION FOR LEARNING allows us to teach our team members the latest and most advanced Home Health and Hospice education. Our LOVE ONE ANOTHER atmosphere shows we work as a team with trust and compassion. The growth we have experienced reveals that we are INTELLIGENT RISK TAKERS with our processes and procedures. But what really sets us apart from all the others is our CUSTOMER SECOND philosophy. Employees are our main and most important focus. We achieve job fulfillment by promoting OWNERSHIP through the independence that Home Health and Hospice offers. Horizon is Idaho’s EMPLOYER OF CHOICE and we want you to join us as we PROVIDE LIFE CHANGING SERVICE to all those we touch. Essential Job Functions/Responsibilities Maintains confidentiality of patient information. Communicates effectively on the telephone with patients, families and staff. Contacts insurance company/case managers to verify patient coverage and obtain information concerning the extent of benefits. Obtains prior authorization for services/visits on all new admissions and recertifications as required. Prepares insurance verification form with data such as names of insurance company and policy older and policy number. Accurately enters insurance information into HCHB system. Prepares an estimate of patient copayment for nurse to deliver to patient and notifies clinician of preauthorized visits. Enters visit authorizations into HCHB system and maintains an audit system for additional visit authorization needs. Reports unauthorized visits to supervisor when applicable. Other duties as assigned by supervisor. The above statements are intended to be a representative summary of the major duties and responsibilities performed by incumbents of this job. The incumbents may be requested to perform job-related tasks other than those stated in this description.

Requirements

Minimum of high school education; preferably with secretarial and computer background.
General knowledge of spelling, punctuation, grammar, medical records and office procedures.
Basic knowledge of office machines.
Basic knowledge of telephone skills.
Aptitude or computer data entry and use of current software systems.
Ability to establish and maintain effective working relationships.
Ability to meet the public and staff as a positive, friendly and professional representative of the agency.
Effective social interaction, communication and organizational skills and the ability to perform a variety of tasks efficiently.

Responsibilities

Maintains confidentiality of patient information.
Communicates effectively on the telephone with patients, families and staff.
Contacts insurance company/case managers to verify patient coverage and obtain information concerning the extent of benefits.
Obtains prior authorization for services/visits on all new admissions and recertifications as required.
Prepares insurance verification form with data such as names of insurance company and policy older and policy number.
Accurately enters insurance information into HCHB system.
Prepares an estimate of patient copayment for nurse to deliver to patient and notifies clinician of preauthorized visits.
Enters visit authorizations into HCHB system and maintains an audit system for additional visit authorization needs.
Reports unauthorized visits to supervisor when applicable.
Other duties as assigned by supervisor.