Insurance Verification Coordinator

Hospice of the Western Reserve•Cleveland, OH

About The Position

Hospice of The Western Reserve operates in celebration of the individual worth of each life, we strive to relieve suffering, enhance comfort, promote quality of life, foster choice in end-of-life care and support effective grieving. Verifies medical insurance coverage for all pay sources. Obtains authorization for services as needed. Performs various clerical functions related to reimbursement of services. Works collaboratively and in conjunction with the Referral, Assessment, Liaison, Care Solutions Center, Centralized Medical Records, and Financial Services teams.

Requirements

Two (2) or more years’ experience in medical insurance verification and healthcare billing preferred.
Two (2) or more years’ experience with electronic medical records preferred.
High School diploma.
Proficient in Microsoft Word, Excel, and Outlook.
Ability to compose and type business correspondence.
Must be detail oriented and able to work in a fast-paced environment.
Must demonstrate strong customer service and communication skills.
Flexibility to work both independently and in a team environment.
Compliance to Annual Vaccination Policy or ability to provide exemption documentation
Ability to provide proof of eligibility to work in the United States.
High level of integrity, ethics and professionalism.

Responsibilities

Identifies new referrals in the EMR (electronic medical record).
Verifies Medicare benefits on the appropriate online site.
Verifies Medicaid and Medicaid Managed Care benefits on the appropriate online site.
Assists and/or performs the verification of commercial insurance benefits as identified, as well as obtains authorizations as needed.
Documents insurance benefits, authorizations, and other pertinent information in the EMR according to established procedures.
Works with appropriate staff and the payors’ case managers to reauthorize services prior to expiration of current authorization period.
Processes explanation of insurance benefits letters for commercial insurance patients and subcontracted services.
Notifies Medicaid of hospice spans for Medicare and Medicaid dually eligible patients via the MITS portal.
Problem solves eligibility, certification, and appeals issues.
Assists in the continued development of the verification, admission, and reimbursement processes.
Completes special assignments/projects and other duties as assigned.
Demonstrates effective Service Excellence skills according to agency guidelines.
Performs identified back-up functions as assigned by supervisor.