Verification Specialist

Alternate Solutions Health Network•Kettering, OH

1d•Remote

About The Position

At Alternate Solutions Health Network, we care for patients where they spend the majority of their time – in their homes. Today we care for patients who need skilled home care and hospice services. We partner with health systems, jointly running home health and hospice agencies that use their brand. This is part of our strategy to ensure each patient has a well-coordinated care plan that remains consistent whether the patient is seeing their primary care physician, receiving treatment in a hospital, or under our care in the home. As a Verification Specialist, you will examine patient eligibility to receive home care services and keep the patient and necessary parties well informed throughout the verification process.

Requirements

High-School graduate or equivalent
2 years of experience in the insurance verification/healthcare field
Knowledge of CMS guidelines
Familiarity with medical terminology
Capable of all physical demands
Compassionate communicator with a positive attitude
Patience when working with patients, families, physicians, and coworkers
Attention to detail
Observant and following directions
Problem solving and create solutions to drive to a course of action
Technological skills to include the ability to research equipment online
Comfortable learning new software and database systems
Ability to use Microsoft Office

Responsibilities

Complete data entry for new patient referrals
Investigate the type and level of insurance coverage
Communicate with the patients and their family regarding the insurance verification and billing process
Ensure a clear understanding of the services covered by the insurance companies and the out of pocket costs to be relayed to the patient
Contact insurance companies to verify patient information and coverage as needed
Evaluate patient eligibility to receive ordered services
Verify Face-to-Face Encounter with physician for billing requirements
Complete hospital hold workflow which may include faxing summary to hospital and following up on hospitalized patients
Understand and practice agency policies and procedures and stays current with CMS guidelines
Perform workflow and data reporting in accordance with CMS guidelines
Complete and submit all required documentation within specified company requirements
Up-date appropriate staff throughout process