Insurance Verification Specialist

Overview:

Pursue your passion and fulfill your purpose at KidsCare! KidsCare Home Health is a multi-award-winning organization who was most recently recognized as a 2023 U.S. Top Workplace. As an award-winning organization, we are looking for dedicated professionals who will embrace the KidsCare core values. At KidsCare we desire to work with individuals who embody the values of the organization which together create our C.A.R.E. culture. In return we offer a full benefits package to include health, dental, and vision insurance, paid time off, 401K, tuition reimbursement, and a hybrid or blended work arrangement (providing balance between in office and work from home).

Responsibilities:

We are currently looking for an Insurance Verification Specialist to join our team! This position ensures all authorizations and verifications are completed and processed in a timely manner and maintain open lines of consistent communication with client families, therapists, and physicians.

Essential Duties and Responsibilities

• Collect patient payment as needed, which may include refund processing.
• Obtain hard benefit insurance verification in detail from patients insurance provider.
• Review quote of benefits with caregivers or provide self-pay options for patients as needed.
• Maintain authorization workflows to obtain routine, initial, and reauthorizations.
• Schedule authorized visits to clinicians caseload.
• Communicate with caregivers and clinicians to provide updates as needed.
• Keep up-to-date and remain knowledgeable with all payor requirements/guidelines and procedural changes for each payor.
• Contact payor sources for outstanding authorizations, including fax authorization requests with necessary clinical documentation to obtain authorization.
• Prepare and fax authorization documentation to physicians for signature.
• Process payor changes when notified.
• Ensure timely processing of discharge and managing clients holds in the organizations healthcare software system.
• Participate in proactive team efforts to achieve departmental and company goals.

• Comply with all company policies, practices, and procedures.
• Perform other duties as assigned.

Qualifications:

Other Qualifications and Skills

• Ability to read and write in simple correspondence with effective speaking in small groups may be required in more than one language.
• Ability to add, subtract, multiply, and divide with whole numbers, including decimals, fractions, and all units of measure.
• Ability to interpret instruction with the ability to solve practical problems with a variety of concrete variables.
• Intermediate computer skills to include Microsoft Office Suite and database activity.
• Handle multiple tasks simultaneously.

Education and Work Experience Requirements

• Zero (0) to one (1) year of administrative experience.
• Specific data entry systems.
• Microsoft Office Suite.
• High school diploma or general education degree (GED); combination of education and 1 year of experience.

Physical Demands/Working Environment

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• While performing the duties of this job, the employee is regularly required to stand, sit; talk, hear, and use hands and fingers to operate a computer and telephone keyboard.
• Ability to sit at a computer for an extended period.
• Light physical activity performing non-strenuous activities of an administrative nature.
• Specific vision abilities required by this job include close vision requirements.
• Moderate noise (i.e., business office with computers, phone, and printers, light traffic).