Insurance Verification Specialist Oversees all aspects of Insurance for the Community Healthcare System. Performs market-wide eligibility verification of benefits for potential Kindred customers. Performs re-verification for Medicare, Medicaid, and commercial insurance payor sources for referrals to the host hospital. Works closely with clinical liaisons, admissions, and Program Director to ensure proper insurance information has been obtained in order to facilitate Admissions. Maintains a current knowledge of Medicare and State Medicaid requirements and practices. Provides education and training for Clinical Liaisons with third party payors and insurance companies. Completes and compiles insurance reports for re-verification.
Qualifications: Education: Bachelor Degree Preferred
Experience:
2-5 years Post-acute healthcare experience in Billing and/or Insurance Verification. At least one year using Database Administration, Common Working File and C-Snap.
Essential Functions:
Checks eligibility and verifies insurance information for Medicare and Commercial carriers.
Utilizes Medicare Common Working File (CWF), to calculate Medicare Days.
Utilizes payor online websites and direct phone contact to check eligibility.
Responds timely with the financials and eligibility to the Clinical Liaison and Program Director.
All financial forms must be legible and completed with all requested information as outlined on the Insuracne Verification forms.
Performs data analysis which is often confidential in nature, to include the use of Excel, SharePoint and Kindred Applications.
Maintains a current knowledge of modification to Medicare and state Medicaid plans as they impact Post Acute Care.
Provides quarterly education to Clinical Liaisons and Program Directors on insurance changes and trends. Provides support and answers questions regarding anything related to insurance.
Provides Ad-hoc tasks as requested by Program Director.
Performs other duties as requested and required.
Conducts job responsibilities in accordance with the standards set out in the Company's Code of Business Conduct, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards.
