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AI Summary
The Reimbursement Coordinator – Eligibility and Authorization is responsible for performing designated intake, insurance verification, eligibility review, authorization submission, review and follow up. Works directly with the payor and internal and external customers towards efficient and effective insurance and authorization
results
We invite you to apply today and join us in shaping the future of healthcare!
Key Responsibilities
Ensures the coordination of intake, insurance, and authorization activities for designated accounts, leading to the timely and accurate verification of coverage and benefits, authorization, submission and follow-up.
Determines and initiates appropriate action to review and verify insurance reports for patient eligibility, benefits, limitations, coordination of benefits, plan coverage, and patient liability.
Review referral documents received from outside or internal sources to properly obtain required information and accurately complete data entry of patient information into the EMR system within the expected time frame.
Verify prior authorization and or pre-service requirements as determined by payor, accurately submit authorization requests via preferred method, combine required documents for submission, enter authorization accurately into patient chart within EMR, complete follow up of submissions to ensure process completion, assist with authorization denials when applicable.
Prepares special handling and/or processing for payors and/or clients.
Perform other job duties as assigned.
Required qualifications
GED or High School Diploma
At least 1-2 years of relevant work experience
Focus on Insurance and Authorization experience in the healthcare industry
Required qualifications
Home Health and Hospice Insurance and Authorization experience
Job Expectations
Willing to work additional or irregular hours as needed
Must work in accordance with applicable security policies and procedures to safeguard company and client information
Must be able to sit and view a computer screen for extended periods of time
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WellSky is where independent thinking and collaboration come together to create an authentic culture. We thrive on innovation, inclusiveness, and cohesive perspectives. At WellSky you can make a difference.
Here are some of the exciting benefits full-time teammates are eligible to receive at WellSky:
- Excellent medical with Rx, dental, and vision benefits
- Mental Health support through EAP
- Generous paid time off, plus 13 paid holidays
- 100% vested 401(K) retirement plans
- Educational assistance up to $2500 per year
WellSky provides equal employment opportunities to all people without regard to race, color, national origin, ancestry, citizenship, age, religion, gender, sex, sexual orientation, gender identity, gender expression, marital status, pregnancy, physical or mental disability, protected medical condition, genetic information, military service, veteran status, or any other status or characteristic protected by law. WellSky is proud to be a drug-free workplace.
Applicants for U.S.-based positions with WellSky must be legally authorized to work in the United States. Verification of employment eligibility will be required at the time of hire. Certain client-facing positions may be required to comply with applicable requirements, such as immunizations and occupational health mandates.
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