Senior Benefits Verification Associate

<p>BAYADA Home Health Care is seeking a full time&nbsp;<strong>Insurance Confirmation Senior Associate&nbsp;</strong>in our<strong> Insurance Confirmation Home Health</strong> office. <strong>This is a <span style="text-decoration: underline;">remote</span> opportunity.</strong></p> <p>The Senior Associate, Eligibility is responsible for obtaining insurance benefits and verifying insurance eligibility and home care benefits. This position will serve as a liaison between the service office providers, insurance carriers, and revenue cycle management functions. A high level of customer service and support is required to effectively communicate eligibility status. The Senior Associate will also provide mentorship and educational support to team members.</p> <p><strong>Hours: 8:30am - 5:00pm EST</strong></p> <p><strong>Responsibilities:&nbsp;</strong></p> <ul> <li>Verify eligibility and care benefit information for designated referrals, including, but not limited to deductibles,&nbsp;co-pays, policy limitations, exclusions, lifetime maximums, and billing addresses.</li> <li>Communicate with the appropriate service office and coordinator when insurance benefits are not adequate,&nbsp;when out-of-pocket expenses are high, when a policy does not require pre-certification, when a client is not&nbsp;eligible, or there are overall plan changes. Update files appropriately.</li> <li>Perform eligibility checks thoroughly and in a timely fashion.</li> <li>Enter plan information for all referrals not requiring a benefit confirmation.</li> <li>Reconfirm benefits for all active clients on a reoccurring and/or ad hoc basis as required.</li> <li>Collect completed payor forms from service office and send them to appropriate department/insurance to&nbsp;release benefit and financial info on clients as needed.</li> <li>Identify if a service office is credentialed and contracted with insurance.</li> <li>Clearly document all benefit and billing information in appropriate systems.</li> <li>Identify when insurance representatives misquote benefits and assist them in retrieving accurate information.</li> <li>Post benefit confirmations to the service offices.</li> <li>Inform collections of changes to client billing information, update bill-to numbers, and answer billing-related&nbsp;questions as needed.</li> <li>Complete insurance verifications to identify changes in benefit eligibility.</li> <li>Obtain eligibility documents from payors or third-party systems to substantiate billing requirements, especially&nbsp;for coordination of benefit procedures.</li> <li>Assist offices in relaying benefit information to clients if necessary.</li> </ul> <p><strong>Qualifications:</strong></p> <ul> <li>Four (4) year college degree.</li> <li>Two (2) to four (4) years of relevant work experience with growing responsibilities. <ul> <li>Minimum 1 year of benefit experience</li> </ul> </li> <li>Prior healthcare and/or home care experience preferred.</li> <li>Proficient knowledge of insurance benefits and contracts.</li> <li>Demonstrated record of strong interpersonal skills and building relationships.</li> <li>Ability to work independently, motivate and be self-motivated, and flexible.</li> <li>Strong customer service skills and demonstrated commitment to quality in all customer encounters.</li> <li>Demonstrated record meeting and/or exceeding goal achievements.</li> <li>Proven ability to multitask and manage competing priorities.</li> <li>Good analytical skills with the ability to problem solve and exhibit good judgement</li> <li>Must have Managed Medicare and Managed Medicaid experience&nbsp;</li> <li>Superb customer service and telephone skills</li> <li>"All hands-on deck" attitude</li> <li>Overall professional demeanor and presentation</li> <li>Strong PC skills</li> <li>Alignment with our core values of <strong><em>compassion</em></strong>, <strong><em>excellence</em></strong>, and <strong><em>reliability</em></strong></li> </ul> <p><em><strong>Base Pay: $24.00-27.00 p