Senior Associate, Insurance Eligibility jobs in United States
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BAYADA Home Health Care · 17 hours ago

Senior Associate, Insurance Eligibility

BAYADA Home Health Care is seeking a full time Insurance Confirmation Senior Associate in their Insurance Confirmation Home Health office. This role is responsible for obtaining and verifying insurance eligibility and home care benefits, serving as a liaison between service office providers and insurance carriers, while also providing mentorship and educational support to team members.

Health CareMedical

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 noteligible, 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 torelease 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-relatedquestions as needed
Complete insurance verifications to identify changes in benefit eligibility
Obtain eligibility documents from payors or third-party systems to substantiate billing requirements, especiallyfor coordination of benefit procedures
Assist offices in relaying benefit information to clients if necessary
Able to work 10:30am - 7:30pm EST

Qualification

Insurance benefits knowledgeManaged Medicare experienceManaged Medicaid experienceHealthcare experienceHome care experienceCustomer service skillsAnalytical skillsPC skillsInterpersonal skills

Required

Four (4) year college degree
Two (2) to four (4) years of relevant work experience with growing responsibilities
Minimum 1 year of benefit experience
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

Preferred

Prior healthcare and/or home care experience

Benefits

Paid holidays
Vacation and sick leave
Vision
Dental and medical health plans
Employer paid life insurance
401k with company match
Direct deposit
Employee assistance program

Company

BAYADA Home Health Care

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BAYADA Home Health Care, one of the largest home health providers with over 325 locations in the U.S. and operations in Germany, India, Irel

Funding

Current Stage
Late Stage

Leadership Team

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David Baiada
Chief Executive Officer
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Sue Moss
Senior Vice President, Payer Strategy & Gov't Affairs
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Company data provided by crunchbase