BAYADA Home Health Care is seeking a full time Insurance Confirmation Senior Associate in our Insurance Confirmation Home Health office. This is a remote opportunity.
The Senior Associate, Eligibility is responsible for obtaining insurance benefits and verifying insurance eligibility and home care benefits. This position will serve as a liaison between the service office providers, insurance carriers, and revenue cycle management functions. A high level of customer service and support is required to effectively communicate eligibility status. The Senior Associate will also provide mentorship and educational support to team members.
Hours: 8:30am - 5:00pm EST
Responsibilities:
- Verify eligibility and care benefit information for designated referrals, including, but not limited to deductibles, co-pays, policy limitations, exclusions, lifetime maximums, and billing addresses.
- Communicate with the appropriate service office and coordinator when insurance benefits are not adequate, when out-of-pocket expenses are high, when a policy does not require pre-certification, when a client is not eligible, or there are overall plan changes. Update files appropriately.
- Perform eligibility checks thoroughly and in a timely fashion.
- Enter plan information for all referrals not requiring a benefit confirmation.
- Reconfirm benefits for all active clients on a reoccurring and/or ad hoc basis as required.
- Collect completed payor forms from service office and send them to appropriate department/insurance to release benefit and financial info on clients as needed.
- Identify if a service office is credentialed and contracted with insurance.
- Clearly document all benefit and billing information in appropriate systems.
- Identify when insurance representatives misquote benefits and assist them in retrieving accurate information.
- Post benefit confirmations to the service offices.
- Inform collections of changes to client billing information, update bill-to numbers, and answer billing-related questions as needed.
- Complete insurance verifications to identify changes in benefit eligibility.
- Obtain eligibility documents from payors or third-party systems to substantiate billing requirements, especially for coordination of benefit procedures.
- Assist offices in relaying benefit information to clients if necessary.
Qualifications:
- Four (4) year college degree.
- Two (2) to four (4) years of relevant work experience with growing responsibilities.
- Minimum 1 year of benefit experience
- Prior healthcare and/or home care experience preferred.
- Proficient knowledge of insurance benefits and contracts.
- Demonstrated record of strong interpersonal skills and building relationships.
- Ability to work independently, motivate and be self-motivated, and flexible.
- Strong customer service skills and demonstrated commitment to quality in all customer encounters.
- Demonstrated record meeting and/or exceeding goal achievements.
- Proven ability to multitask and manage competing priorities.
- Good analytical skills with the ability to problem solve and exhibit good judgement
- Must have Managed Medicare and Managed Medicaid experience
- Superb customer service and telephone skills
- "All hands-on deck" attitude
- Overall professional demeanor and presentation
- Strong PC skills
- Alignment with our core values of compassion, excellence, and reliability
Base Pay: $24.00-27.00 per hour depending on qualifications
As an accredited, regulated, certified, and licensed home health care provider, BAYADA complies with all state/local mandates.
BAYADA is celebrating 50 years of compassion, excellence, and reliability. Learn more about our 50th anniversary celebration and how you can join in here.
BAYADA Home Health Care, Inc., and its associated entities and joint venture partners, are Equal Opportunity Employers. All employment decisions are made on a non-discriminatory basis without regard to sex, race, color, age, disability, pregnancy or maternity, sexual orientation, gender identity, citizenship status, military status, or any other similarly protected status in accordance with federal, state and local laws. Hence, we strongly encourage applications from people with these identities or who are members of other marginalized communities.