Home Healthcare Financial Services Representative

General Purpose:

Responsible for various financial services processes to support authorization and payroll.

Essential Functions:

• Verifies insurance coverage for potential new patients and re-verifies insurance coverage for existing patients.

• Reviews requests for authorization needed based upon insurance standards while drawing upon experience and general knowledge. 

• Reviews documentation or contacts the provider when necessary to supplement the order to prove medical necessity. 

• Handles calls related to client benefit eligibility verification and authorization requests.

• Maintains up to date information on assigned insurance companies. Documents and communicates relevant changes to appropriate staff.

• Ensures appropriate documentation is available and complete before submitting the authorization to the insurance company to avoid repetitious submissions and denials.

• Submits all authorizations with correct diagnosis codes.

• Enters any authorization numbers and expiration dates into the system as required for appropriate tracking.

• Supports payroll processing. Matches timesheets to verify visits in the system. Notes discrepancies and review with Supervisor to ensure accurate payroll administration.

• Provides reports and information to others as needed to support billing and payroll activities. 

• Complete all assigned tasks with a high degree of accuracy and within allotted timeframe.

• Performs other assignments as requested. 

• May have access to personal health information (“PHI”) necessary to fulfill the above duties and responsibilities.  Access to use and ability to disclose PHI is further defined by each organization/department.

Minimum Education & Experience Requirements:

• High school diploma.  Associates degree, preferred. 

• Two (2) years relevant office experience, preferably in the healthcare industry.

• Or an equivalent combination of experience and education.

Knowledge, Skills & Abilities Required:  

• The ideal candidate will be detail oriented, highly organized and thrive in a team environment. 

• Microsoft Office experience and Intermediate Excel skills are a plus. 

• Strong written and verbal communication skills.

• Familiarity with Google docs and Google apps.

• Understanding of insurance websites and form fields for authorization submission highly preferred.
  

Working Conditions & Physical Effort:  

• Work is normally performed in a typical interior/office work environment.

• Physical activity is sedentary and may require occasional lifting or carrying up to 10 lbs.

• Ability to sit in front of a computer for long periods of time.