Job Description

Job Description

Job Description

The Visiting Nurse Association of Florida is a Service Driven organization that prides itself in Excellence. We seek Motivating professionals who will join our Committed team in our Stuart office.

Summary:

As an insurance and authorization specialist, you will be responsible for obtaining timely authorization and verification of insurance benefits. Calling insurance companies to obtain home health care benefit information and determining insurance coverage. Responsible for obtaining initial authorization and renewal authorizations. Collaborate with the clinical team regarding supporting medical documentation in accordance with formulary guidelines.

Insurance/Authorization Specialist Duties and Responsibilities:

· Contact health insurance companies to verify patient benefits and determine prior authorization requirements as well as obtain details of patient deductible, out of pocket max and coinsurance.

· Responsible for entering data in an accurate manner, updating patient benefit information in the EMR system and verifying that existing information is accurate.

· Identify documentation needed to support requests for prior authorization and work with the clinical team to obtain these if not already on file.

· Obtain insurance authorizations prior to and during patient care. As well as the ability to communicate with insurance companies to resolve any authorization issues.

· Re-verifying existing patient insurance coverage and determining if an insurance benefit plan considers services appropriate based on patient need.

· Demonstrates proficiency in working with insurance companies and has extensive knowledge of different types of coverage and policies.

· Demonstrates excellent multitasking skills, with the ability to work on numerous patient charts at once. Is very detail-oriented and organized and maintains accurate patient insurance records.

· Possesses the ability to focus and work quickly. Patient insurance verification requests for eligibility and authorization are processed in a timely manner.

· Is proficient in the use of Availity and insurance-specific portals to accurately verify insurance coverage and patient responsibility.

· Utilizes problem-solving skills in verifying inaccurate information recorded in the EMR system by the use of Availity, the insurance portal, or calling the insurance company.

· Maintains and adheres to the company's OSHA, HIPAA, and Compliance regulations.

· Other duties as assigned.

· This is not a remote position.

Qualifications/Experience:

· Insurance verification/Authorization: 1 year (Preferred)

· Home Health Experience (Preferred)

· Portal experience such as Availity or insurance-specific portals (Preferred)

· Ability to prioritize and work under pressure

· Time Management

· Documentation Skills

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