Insurance Coordinator

Trinity Health • Waterloo, IA

1d

About The Position

Under the general guidance of the Director of Rehabilitation Services, the Insurance Coordinator is responsible for leading outpatient therapy patient insurance eligibility and authorizations, ensuring accuracy and compliance for each individual. This role involves implementing and teaching information related to admitting, billing, and insurance functions to other stakeholders, and delegating tasks when appropriate. The coordinator ensures accuracy in all aspects of outpatient therapy related to admitting, billing, and insurance.

Requirements

• High school diploma or equivalent.
• Experience within a hospital or clinic environment performing prior-authorizations and denial management.

Nice To Haves

• Knowledge of medical terminology is preferred.
• Associate degree in finance, accounting, business administration, or related field, preferred or relatable experience.

Responsibilities

• Performing department daily scheduling, registration, and all insurance activities for outpatient rehabilitation services.
• Utilizing systems to ensure appropriate therapy CPT and ICD-10 codes were utilized, with an understanding of physical, occupational, and speech therapy services.
• Reviewing rehab denials and write-off reports and being directly involved in the appeal processes.
• Monitoring payer websites to maximize reimbursement based on services delivered.
• Performing pre-service check processes, including pre-authorization and medical necessity review as indicated by patient insurance carrier.
• Applying knowledge of specific payer payment rules to ensure timely claim resolutions.
• Reviewing, providing, and submitting additional information, including medical necessity and documentation for appeals, as necessary.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED