Verification Specialist

Alternate Solutions Health Network•Kettering, OH

2d•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. You won’t find our brand in many places because we partner with health systems, jointly running home health and hospice agencies that use their brand. This is part of our strategy. By being part of the health system team, we can 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 are 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 and familiarity with medical terminology.
Capable of all physical demands.
Compassionate communicator with a positive attitude.
Patience is a virtue when working with patients, families, physicians, and coworkers.
Attention to detail is critical, as is being 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 and the ability to use Microsoft Office.

Responsibilities

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.
Update appropriate staff throughout process.
Complete data entry for new patient referrals.
Investigate the type and level of insurance coverage.