Insurance Verification & Authorization Representative - Home Health

Schuylkill • Allentown, PA

12d • Onsite

About The Position

Lehigh Valley Health Network (LVHN) is seeking an Insurance Verification and Authorization Representative for Home Health. This full-time, day shift position involves obtaining and monitoring insurance authorization for home health and hospice patients to ensure database integrity and facilitate claims processing. The role requires documenting patient authorization requirements, deductibles, co-payments, and coinsurance responsibilities, as well as completing accurate insurance information in case communication notes for clinicians. The representative will also coordinate and submit appeals for denied payments due to authorization or other insurance complications, adhering to deadline restrictions. This position functions as a resource for insurance verification and authorization issues and requires following computer system, department operational procedures, and training guidelines.

Requirements

• High School Diploma/GED
• Demonstrated flexibility and effective problem solving in accommodating and meeting customer needs.
• Excellent computer skills.

Nice To Haves

• Associate’s Degree
• Less than 1 year Health care office setting
• Less than 1 year Authorization

Responsibilities

• Obtains authorization for all services based on insurance to ensure database integrity and facilitate claims processing.
• Documents patient authorization requirements, deductibles, co-payments, and coinsurance responsibilities.
• Completes accurate and complete insurance information into case communication notes for clinicians.
• Coordinates appeal processes for denied payment due to authorization or other insurance complications.
• Writes and submits appeals with substantiating documentation within deadline restrictions.
• Follows computer system, department operational procedures, and training guidelines to obtain accurate insurance information.
• Functions as a resource regarding insurance verification and authorization issues.

What This Job Offers

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