Senior Associate, Insurance Eligibility

BAYADA Home Health Care • Boulder, CO

9d • $24 - $27 • Remote

About The Position

BAYADA Home Health Care is seeking a full time Insurance Confirmation Senior Associate in our Insurance Confirmation Home Health office. This is a remote opportunity.
The Senior Associate, Eligibility is responsible for obtaining insurance benefits and verifying insurance eligibility and home care benefits. This position will serve as a liaison between the service office providers, insurance carriers, and revenue cycle management functions. A high level of customer service and support is required to effectively communicate eligibility status. The Senior Associate will also provide mentorship and educational support to team members.
Preferred location: Central or Pacific Time Zones | Hours: 8:30am - 5:00pm

Requirements

• Four (4) year college degree.
• Two (2) to four (4) years of relevant work experience with growing responsibilities.
• Minimum 1 year of benefit experience
• Prior healthcare and/or home care experience preferred.
• Proficient knowledge of insurance benefits and contracts.
• Demonstrated record of strong interpersonal skills and building relationships.
• Ability to work independently, motivate and be self-motivated, and flexible.
• Strong customer service skills and demonstrated commitment to quality in all customer encounters.
• Demonstrated record meeting and/or exceeding goal achievements.
• Proven ability to multitask and manage competing priorities.
• Good analytical skills with the ability to problem solve and exhibit good judgement
• Must have Managed Medicare and Managed Medicaid experience
• Superb customer service and telephone skills
• "All hands-on deck" attitude
• Overall professional demeanor and presentation
• Strong PC skills
• Alignment with our core values of compassion, excellence, and reliability

Nice To Haves

• Prior healthcare and/or home care experience preferred.

Responsibilities

• Verify eligibility and care benefit information for designated referrals, including, but not limited to deductibles, co-pays, policy limitations, exclusions, lifetime maximums, and billing addresses.
• Communicate with the appropriate service office and coordinator when insurance benefits are not adequate, when out-of-pocket expenses are high, when a policy does not require pre-certification, when a client is not eligible, or there are overall plan changes. Update files appropriately.
• Perform eligibility checks thoroughly and in a timely fashion.
• Enter plan information for all referrals not requiring a benefit confirmation.
• Reconfirm benefits for all active clients on a reoccurring and/or ad hoc basis as required.
• Collect completed payor forms from service office and send them to appropriate department/insurance to release benefit and financial info on clients as needed.
• Identify if a service office is credentialed and contracted with insurance.
• Clearly document all benefit and billing information in appropriate systems.
• Identify when insurance representatives misquote benefits and assist them in retrieving accurate information.
• Post benefit confirmations to the service offices.
• Inform collections of changes to client billing information, update bill-to numbers, and answer billing-related questions as needed.
• Complete insurance verifications to identify changes in benefit eligibility.
• Obtain eligibility documents from payors or third-party systems to substantiate billing requirements, especially for coordination of benefit procedures.
• Assist offices in relaying benefit information to clients if necessary.
• Able to work 10:30am - 7:30pm EST

Benefits

• BAYADA Home Health Care offers the stability and structure of a national company with the values and culture of a family-owned business.
• Award-winning workplace: proud to be recognized as a Best Place to Work by Newsweek, Forbes, and Glassdoor.
• Weekly pay
• AMAZING culture: we are a mission driven nonprofit organization, focused around three core values of compassion, reliability, and excellence.
• Strong employee values and recognition: we utilize a BAYADA Celebrates page for daily recognition, along with Hero spotlights, Key Action of the Week meetings to connect back to our mission and celebrate staff, discounts/perks and partnerships, an Awards Weekend trip, and more.
• Diversity, equity, inclusion, and belonging: Join groups like our Women in Limitless Leadership Employee Resource Council, Lean In circles, Racial and Ethnic Diversity (RED) Council, Pride LGBTQIA+ Council, Military Community Network, Solutions and Accessibility for Equality (SAFE) Council, Fostering Acceptance Inspiring Trust and Harmony (F.A.I.T.H), and more.
• Growth opportunities: advancement opportunities, continued education opportunities, Udemy courses, webinars, and more
• Benefits: BAYADA Home Health Care offers a comprehensive benefits plan that includes the following: Paid holidays, vacation and sick leave, vision, dental and medical health plans, employer paid life insurance, 401k with company match, direct deposit and employee assistance program. To learn more about BAYADA Home Health Care benefits, https://www.bayada.com/benefits
• As an accredited, regulated, certified, and licensed home health care provider, BAYADA complies with all state/local mandates.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 5,001-10,000 employees