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Hospice Insurance Verification & Authorization Coordinator
Graham Healthcare Group. Obtain detailed and accurate benefit information using payer portals, phone, or fax .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in insurance verification and authorization processes, with a strong understanding of Medicare, Medicaid, and third-party insurance requirements. Proficient in utilizing Homecare Homebase (HCHB) and payer portals to manage patient benefit information effectively.
Highest-signal resume keywords
Homecare Homebase ExperienceInsurance VerificationAuthorization ManagementMedicare And Medicaid KnowledgeMicrosoft Office Proficiency
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Insurance VerificationAuthorization ManagementBenefit DocumentationPayer Portal NavigationPatient Chart ManagementEligibility VerificationDeductible And Co-Pay DocumentationFunding Source CoordinationCritical ThinkingMedical Billing
Soft Skills
Effective CommunicationIndependent WorkTeam CollaborationProblem SolvingAttention To Detail
Tools & Technologies
Homecare Homebase (HCHB)Payer PortalsMicrosoft Office Suite
Certifications & Qualifications
Professional LicenseCertificate Or Registration In Good Standing
Industry Keywords
MedicareMedicaidThird-Party InsuranceAuthorization RequirementsInsurance Verification Processes
About the role
Key responsibilities & impact- Obtain detailed and accurate benefit information using payer portals, phone, or fax
- Validate and document payer information in the EMR
- Document deductibles, co-pays, co-insurance, and out-of-pocket maximums in patient charts
- Monitor insurance-related workflow tasks, including Medicare eligibility, insurance verification, eligibility alerts, authorizations, reauthorizations, and resumption of care
- Review entitlement verification reports and investigate questionable answers
- Review insurance changes and funding source updates
- Reverify Medicaid patients monthly to monitor HMO status
- Reverify current patient insurance monthly for payer changes or other agencies
- Contact patients, hospitals, physician offices, and insurance companies to obtain or clarify information
- Assist scheduling with funding source problems
- Coordinate transfer of agency/provider-of-choice forms with clinical staff and other agencies
- Obtain initial, prior, ongoing, and reauthorization approvals through phone, fax, or payer portals
- Maintain the authorization tab in HCHB
- Provide clinical information requested by insurance companies
- Notify internal clinical staff of authorization approvals and denials
- Assist billing with insurance verification and authorization discrepancies that could delay claim submission
- Establish thorough knowledge of payer portals
- Comply with company Core Values and Core Competencies
- Perform other duties as assigned
Requirements
What you’ll need- Homecare Homebase Experience (HCHB) is required
- Must live in the Eastern or Central Time Zone
- Must be willing to work every other Saturday
- Associate degree or combination of experience and business courses preferred
- Minimum of one year of previous experience in insurance verification, authorization, or medical billing
- Proficiency in Microsoft Office Suite
- Knowledge of Medicare, Medicaid, and third-party insurance and authorization requirements
- Knowledge of insurance websites
- Knowledge of HomeCare Homebase preferred
- Must maintain a professional license, certificate, or registration in good standing, as applicable
- Availability weekends, holidays, and after hours based on business needs
- Effective verbal and written communication skills
- Ability to work independently and within a multidisciplinary team
- Ability to think critically and act independently when resolving benefit discrepancies
- Successful completion of a drug screen prior to employment
- Legally authorized to work in the United States
Benefits
Comp & perks- Medical benefits: health, vision, and dental insurance
- 401K and pension with 4% employer contribution
- 15 days PTO
- Company-paid life insurance and disability benefits
- Pre-tax FSA and HSA plans
- Generous PTO packages
- 50% tuition discounts for selected courses offered by Purdue and Kaplan
- Opportunity for advancement
- Remote work arrangement
- Competitive pay