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Job Details


Requisition Number 17-1235
Post Date 11/14/2017
Title Insurance Coordinator, Full time
Job Type Full Time
City Rochester
State NY
Description

Summary:

Under the general direction of the Manager of Insurance Coordination and/or designee, and in accordance with corporate goals, this position verifies all existing patient insurance information, documents, communicates and corrects billing system to reflect accurate coverage as per payor specifications and regulations. The position is essential to maximize revenue and reduce the number of uncollected account receivables.

Essential Responsibilities/Accountabilities:

Level I

• Accurately enters, verifies and sequences all incoming referrals for Lifetime Care and all related entities. Adheres to time frames noted within policy to create an efficient and effective admission flow which includes proper documentation.

• Accesses information from various sources including on line verification systems such as EPACES and commercial payer websites and provider lines to access the most current information.

• Re-verifies insurance for each open and active patient on service. Uses all systems as appropriate for the payor/insurance plan, on a monthly basis or as needed.

• Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies’ mission and values and adhering to the Corporate Code of Conduct.

• Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures.

• Regular and reliable attendance is expected and required.

• Performs other functions as assigned by management.

Level II – Performs similar functions as level I, as well as:

• Organizes the inquiries from Patient Financial Service Department staff as well as clinical staff to determine proper, accurate and timely sequencing of payors to insure accurate billing.

• Researches and resolves issues resulting in necessary changes to patients’ accounts and the liability for payment of services provided.

• Accurately documents patient insurance information, determines proper sequence of coordination of benefits, clearly communicates to all departments and corrects billing system to reflect accurate coverage.

• Contacts resources to resolve discrepancies in insurance information, including patients, physician’s offices and County Department of Social Services (DSS) offices.

• Communicates with peer nurses, team managers, and supervisors via telephone or e-mail to discuss case and the necessary steps that need to be taken in order for payment to occur.

• Shares information and knowledge learned (with co-workers) while working in the various on-line systems with other departmental staff and management.

• Works collaboratively with Home Care Coordinators and Insurance Coordination staff to rectify coordination of benefit issues.

Level III – Performs other functions as level II, as well as:

• Conducts research to obtain Medicare numbers when the patient is enrolled in a Medicare Advantage Plan and no Medicare number has been provided.

• Performs analysis from existing systems, work flows and provides recommendations to improve efficiency.

• Understands appropriate prioritization of issues and when to elevate problems to management.

Requirements

Level I

• High School Diploma or equivalent with a minimum of three years of experience in a related health care field.

• Excellent organization, communication and customer service skills required for success.

• Must be familiar with Microsoft Windows including Microsoft Office.

• Attention to detail.

Levels II and III – requires similar qualifications as level I, as well as:

• Associate’s degree in Business Administration or related certification/degree with a minimum of five years’ experience in a related health care field.

• Must have working knowledge of all types insurances including Medicare, Medicaid, HMO, Worker’s Comp, No Fault and other Commercial Liability including pertinent regulations for billing. Physical Requirements Person must be able to work on computer 6-8 hours a day with excellent data entry and documentation skills.

In support of the Americans with Disabilities Act, this job description lists only those responsibilities and qualifications deemed essential to the position. Equal Opportunity Employer

  • We are an Equal Opportunity Employer.
  • Please view Equal Employment Opportunity Posters provided by OFCCP here.
  • We are an Equal Opportunity Employer, and as such affirm the right of every person to participate in all aspects of employment without regard to race, color, sex/gender, age, disability, religion, creed, citizenship status, national origin, veteran status, military status, marital status, familial status, domestic violence victim status, sexual orientation, gender identity, predisposing genetic characteristic, genetic information, or any other status protected under the law.
  • The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information.
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