Insurance Verification and Authorization Representative

Posted 18 Days Ago
Be an Early Applicant
Home, KS
1-3 Years Experience
Healthtech • Pharmaceutical
The Role
The Insurance Verification and Authorization Representative is responsible for verifying insurance benefits and obtaining authorizations according to regulatory requirements. Key duties include processing correspondence from payors, resolving coverage issues, and preparing invoices.
Summary Generated by Built In

It’s inspiring to work with a company where people truly BELIEVE in what they’re doing!

When you become part of the Chapters Health Team, you’ll realize it’s more than a job. It’s a mission. We’re committed to providing outstanding patient care and a high level of customer service in our communities every day. Our employees make all the difference in our success!

Role:
The Insurance Verification and Authorization Representative performs verification of benefits and obtains authorizations in accordance with all state, federal and third party payor contractual requirements.

Qualifications:• High School Diploma or GED• Minimum of one (1) year of medical billing and collection or office experience • Knowledge of third party billing and state and federal collection regulations preferred• Ability to prioritize and multi-task independently with little guidance• Must be self-motivated and service oriented• Excellent written and verbal communication skills• Accurate typing and data entry skills Competencies:• Satisfactorily complete competency requirements for this position. Responsibilities of all employees: • Represent the Company professionally at all times through care delivered and/or services provided to all clients.• Comply with all State, federal and local government regulations, maintaining a strong position against fraud and abuse. • Comply with Company policies, procedures and standard practices.• Observe the Company's health, safety and security practices.• Maintain the confidentiality of patients, families, colleagues and other sensitive situations within the Company.• Use resources in a fiscally responsible manner.• Promote the Company through participation in community and professional organizations.• Participate proactively in improving performance at the organizational, departmental and individual levels.• Improve own professional knowledge and skill level.• Advanced electronic media skills.• Support Company research and educational activities.• Share expertise with co-workers both formally and informally.• Participate in Quality Assessment and Performance Improvement activities as appropriate for the position. Job Responsibilities:• Performs insurance benefit verification for all payors.• Obtains authorization as required by plan benefit.• Processes incoming correspondence from payors.• Resolves any issues with coverage and escalates complicated issues to the Supervisor.• Ensures timely, complete and accurate processing of benefit information.• Prepares monthly nursing home room and board invoices.• Collaborates with Medicaid Eligibility Vendor to obtain Medicaid eligibility.• Obtains patient responsibility payment as needed.• Performs other duties as assigned.

This position requires consent to drug and/or alcohol testing after a conditional offer of employment is made, as well as on-going compliance with the Drug-Free Workplace Policy.

The Company
Temple Terrace, Florida
646 Employees
On-site Workplace
Year Founded: 1983

What We Do

“We are a part of the circle of life. It’s as touching and important to be a part of the end of life as it is to be at the beginning. We provide our patients dignity, comfort and quality of life at the end of their journey. Our job is so much more about life than death! Being present during this sacred time is truly and honor, a calling.“ -Jane, LPH Registered Nurse

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As a progressive leader and premier healthcare organization, Chapters Health System is dedicated to delivering innovative care throughout chronic illness progression and beyond. Since 1983 as a community-based, not-for-profit organization, Chapters Health has provided choices, education and guidance through its managed affiliates.

Chapters Health affiliates include ASSURITY DCE, Chapters Health CareNu, Chapters Health Foundation, Chapters Health Pharmacy, Chapters Health Staffing, Chapters Health Hospice in Alachua, Martin, Monroe, Pinellas and St. Lucie counties; Cornerstone Hospice in Hardee, Highlands, Lake, Marion, Orange, Osceola, Polk and Sumter counties within Florida and Cherokee, Cobb, Fulton and Gwinett counties within Georgia; Good Shepherd Hospice in Polk, Highlands and Hardee counties; Hospice of Okeechobee; HPH Hospice in Pasco, Hernando and Citrus counties; and LifePath Hospice in Hillsborough County.

All offerings are provided to improve the patient/family experience well in advance of end-of-life needs. In 2023, Chapters Health was named a Top Workplaces USA award-winner; in 2022, earned certified status for information security from HITRUST and for the fifth consecutive year was recognized as a great workplace in the Aging Services category by the independent analysts at the Great Place to Work® Institute.

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