Senior Benefits Verification Associate

BAYADA Home Health Care•Parsippany, NJ

17h•$24 - $27•Remote

About The Position

BAYADA Home Health Care is seeking a full-time Senior Associate, Eligibility for its Insurance Confirmation Home Health office. This is a remote opportunity. The role obtains insurance benefits and verifies insurance eligibility and home care benefits. It serves as a liaison between service office providers, insurance carriers, and revenue cycle management functions, while providing customer service and communicating eligibility status. The Senior Associate also mentors and provides educational support to team members. The stated hours are 8:30 a.m. to 5:00 p.m. EST. Base pay is $24.00–$27.00 per hour, depending on qualifications. BAYADA complies with applicable state and local mandates and is an Equal Opportunity Employer.

Requirements

Four-year college degree.
Two to four years of relevant work experience with growing responsibilities.
At least one year of benefits experience.
Proficient knowledge of insurance benefits and contracts.
Demonstrated interpersonal skills and ability to build relationships.
Ability to work independently, motivate oneself and others, and remain flexible.
Strong customer service skills and commitment to quality in customer interactions.
Demonstrated record of meeting or exceeding goals.
Ability to multitask and manage competing priorities.
Good analytical and problem-solving skills and sound judgment.
Managed Medicare and Managed Medicaid experience.
Strong customer service and telephone skills.
An “all hands-on deck” attitude.
Professional demeanor and presentation.
Strong PC skills.
Alignment with BAYADA’s core values of compassion, excellence, and reliability.

Nice To Haves

Prior healthcare and/or home care experience.

Responsibilities

Verify eligibility and care benefit information for designated referrals, including deductibles, co-pays, policy limitations and exclusions, lifetime maximums, and billing addresses.
Communicate with the appropriate service office and coordinator about inadequate insurance benefits, high out-of-pocket expenses, policies that do not require pre-certification, ineligible clients, and plan changes; update files as appropriate.
Perform eligibility checks thoroughly and promptly.
Enter plan information for referrals that do not require benefit confirmation.
Reconfirm benefits for active clients on a recurring or ad hoc basis as required.
Collect completed payor forms from service offices and send them to the appropriate department or insurer to release benefit and financial information about clients as needed.
Identify whether a service office is credentialed and contracted with an insurer.
Clearly document benefit and billing information in appropriate systems.
Identify when insurance representatives misquote benefits and assist them in retrieving accurate information.
Post benefit confirmations to 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-benefits procedures.
Assist offices in relaying benefit information to clients when necessary.
Provide mentorship and educational support to team members.