Training schedule is 8:30a to 5p, Monday to Friday for the first 30-60 days.
Hours: Mon.-Fri. 10:30a.m. to 7pm (Possible Holiday Coverage)
Position Purpose:
The Insurance Specialist is responsible for processing all incoming referrals received by THHS Central Intake ensuring the orders are processed in an efficient and accurate manner. Responsible for the creation and verification of all client account billings to all third party and private payers utilizing the appropriate software programs. Compiles financial data required to verify accuracy of the client’s fee source/method of payment to assure timely reimbursement. Obtains initial and ongoing authorization for services as appropriate. Documents payer source data and authorization activity to online billing system. Required to comply with all HCFA/JCAHO/Compliance regulations. In addition, the position provides assistance to the clinical customer service coordinator and THHS billing departments related to special projects, audits and regular monthly reporting. Will support multiple sites.
What You Will Do:
Compiles financial data required to verify accuracy of client insurance/payer source/method of payment to asst. Documents payer source data and authorization activity in online billing system to ensure accurate and timely submission of claims.
Stays current with all third-party insurance regulations and criteria.
Able to effectively respond to clients/families/staff and others regarding insurance questions and concerns.
Confers with referral sources as needed in relation to alternative fee sources/funding.
Demonstrates accuracy and completeness in all data entry and reports.
Maintains a working knowledge of applicable Federal, State, and local laws and regulations, Trinity Health Organization Integrity Program, Code of Ethics, as well as other policies and procedures to ensure adherence in a manner that reflects honest, ethical, and professional behavior.
Assists in the referral processing of all THHS clients from receipt of referral through the insurance verifications of all third-party payers. Assures the creation, accuracy, and maintenance of all client account insurance activity.
Provides direction and on-going assistance to site team staff relating to the client’s insurance qualifications needed to assure accurate revenue to agency.
Is proficient at the use of automated tools and makes appropriate decisions related to the relationship of the action required and the tool used.
Obtains initial authorization, if appropriate. Audit authorizations for accuracy and determine if delay/deny policy needs to be invoked.
Benefits:
Day 1 Benefits - Health, dental and vision insurance
Daily Pay
Employee Referral Reward Program
Short and long-term disability
Tuition Reimbursement
403b
Generous paid time off
Comprehensive orientation
Pay range: $17.87 - $22 per hour plus $3 shift differential pay
Minimum Qualifications:
High School diploma or equivalent: two years college experience preferred.
Two years of experience in coverage verification/benefit determination preferred. Two years home care experience preferred.
Knowledge of governmental reimbursement criteria. Knowledge of third party / managed care contracts related to Agency services is preferred.
Computer literate. Experience with Agency’s current software platforms preferred.
Working knowledge of standard office equipment.
Must be able to communicate effectively with internal and external customers.
Demonstrates a commitment to customer service and accepts challenges to improve processes.
Ability to consistently demonstrate commitment to the mission and Organizational Code of
Ethics, and adhere to the Compliance Program.
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Our Commitment to Diversity and Inclusion
Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.