Verification Authorization Coordinator
About The Position
The Verification Authorization Coordinator verifies patient eligibility and benefits and obtains authorizations, when required, for home care and hospice services from insurance payors. The role reviews referral information, gathers authorization and payor information, and enters benefit and authorization details into the applicable EMR system. It also supports Care Centers and other departments, responds to inquiries, helps resolve verification and authorization issues, and provides administrative assistance as needed. The coordinator must comply with medical-record confidentiality requirements, company policies, procedures, regulatory mandates, and the Amedisys Compliance Program. The position may also access Medicare’s Common Working File to verify eligibility when a patient’s private insurance coverage has ended, if applicable. The role is rewarded and recognized for performance and offers development opportunities for other roles.
Requirements
- High school diploma or equivalent.
- At least 2 years of experience in medical office or home health benefit verification or billing.
- Demonstrated knowledge of commercial insurance carriers’ guidelines and criteria for verification, authorization, and reimbursement.
- Demonstrated familiarity with insurance billing and terminology.
Nice To Haves
- Post-secondary education or training in business or medical billing/collections.
Responsibilities
- Review referral information for accuracy in the applicable EMR system supplied by the Care Center.
- Obtain authorizations when required while maintaining compliance with medical-record confidentiality regulations.
- Obtain authorizations from private insurance and other payor sources requiring authorization via telephone, facsimile, or online systems.
- Obtain information from agencies, when necessary, to assist with authorizations and reauthorizations from private insurance and other payor sources.
- Assist other departments and Care Centers with efficient collection of client and payor information to ensure accuracy.
- Enter patient benefit and authorization information into the applicable EMR system.
- Respond to calls, emails, and other inquiries about outstanding referrals and authorization information.
- Provide other administrative support to the department as needed.
- Complete Payor Information Forms and Payor Change Request Forms when needed to meet payor and client needs and ensure accurate reimbursement.
- Update the Contracting Coordinator about payor information changes.
- Communicate efficiently, effectively, and promptly to resolve issues related to verification and authorization processes.
- Access Medicare’s Common Working File to verify eligibility when a patient has terminated private insurance coverage, if applicable.
- Update the Admissions Operations Manager and/or Director about needed team efficiencies and system problems.
- Comply with policies, procedures, and regulatory mandates, including the terms of the Amedisys Compliance Program.
- Perform other duties as assigned.
Benefits
- Comprehensive benefits package, subject to eligibility requirements.
- Incentive and recognition programs, subject to eligibility requirements.
- Equity stock purchase, subject to eligibility requirements.
- 401(k) contribution, subject to eligibility requirements.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
