Senior Review Specialist

Integrated Home • Miramar, FL

12d

About The Position

Who we are: IHCS provides an Integrated Delivery System in the home setting, which includes, DME, Respiratory, Home Health and Home Infusion services. IHCS has a select network of Medicare and/or Medicaid Certified and Accredited providers to respond to the needs of our patients – 24/7. We operate with the sole intent of providing the highest quality in-home care services that improve and enhance the daily living for our patients, where our patients are #1 Our delivery model is trusted by national Managed Care Organizations (MCOs), physicians and patients, positioned with over two decades of expertise as the market leader in value-based Home Health, Durable Medical Equipment, and Home Infusion Services. We currently serve over 2 million lives throughout the nation and the Commonwealth of Puerto Rico. Join our team as we strive for excellence through teamwork delivering high quality care to our patients through Exceptional Customer Service, Proven Outcomes, and Seamless Care. Offering a competitive compensation package, including but not limited to; Medical, Vision, Dental, Short- and Long-term insurance 6+ Days of Holidays Pay 12+ days of PTO Employer paid life insurance 401K with employer contribution Wellness program with reward incentives Employee recognition and reward programs Comprehensive paid training program What will you be doing: The Senior Review Specialist is responsible for submitting completed Second Level Review (SLR) forms to health plans (HP) along with the necessary documentation to obtain determinations for requested services. This role involves verifying patient and order information, ensuring accuracy of information to be presented to the health plan, insurance coverage and authorization. This role requires excellent attention to detail and writing skills.

Requirements

• Strong understanding of insurance coverage, healthcare regulations, and DME procedures.
• 2 + in utilization management, insurance verification, or related healthcare setting.
• Strong understanding of insurance coverage, healthcare regulations, and DME procedures
• Ability to use various computer programs and applications, IE EMR/EHR
• Proficient in Microsoft Office Suite (Word, Excel, Outlook)
• Ability to multi-task, set priorities and manage time effectively

Nice To Haves

• Bilingual Spanish a plus
• Certification a plus

Responsibilities

• The Senior Review Specialist is responsible for submitting completed Second Level Review (SLR) forms to health plans (HP) along with the necessary documentation to obtain determinations for requested services.
• This role involves verifying patient and order information, ensuring accuracy of information to be presented to the health plan, insurance coverage and authorization.
• This role requires excellent attention to detail and writing skills.

Benefits

• Medical
• Vision
• Dental
• Short- and Long-term insurance
• 6+ Days of Holidays Pay
• 12+ days of PTO
• Employer paid life insurance
• 401K with employer contribution
• Wellness program with reward incentives
• Employee recognition and reward programs
• Comprehensive paid training program

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: No Education Listed