Remote role - Office location Arizona, will consider candidates out of state.

Job Summary:
Ensures that all phases of the patient intake, verification, and authorization process are completed in a timely and thorough manner. Tracks and requests all ongoing treatment authorizations and requests retro-authorization if necessary. Works closely with the Centers, A/R, Patient Placement, and Patient Services to resolve collection problems resulting from incorrect insurance information, new account/patient setup, transfers, insurance status changes, new and existing insurance coverage changes, EMR updates, and insurance ineligibility.

• Establishes and utilizes organized systems to track requests and complete intake approval in a timely manner; functions as initial point of contact for new patient admission, visitors, and transfers from other dialysis centers
• Notifies the dialysis center promptly of approved referrals and keeps the center informed about delays or issues surrounding new patients
• Develops a personal and electronic network of contacts with IPAs, medical groups and payer Utilization Review Departments to facilitate new and ongoing authorizations; uses appropriate systems reports to ensure no lapses in authorization
• Responds to requests from A/R staff to verify insurance coverage and/or obtain new authorization when retro-active notice of changes in insurance are received or detected in the collection process
• Accurately determines Coordination of Benefits dates and correctly loads current and future Medicare dates in the Billing System patient record
• Reviews New Scanned Documents in Patient360 daily to review new insurance cards updates, as well as reviews Medical Evidence Report Forms received from the center to confirm accurate and timely demographic updates that may impact coverage and coordination of benefits
• Manages workflow and worklist items in Patient360
• Insures the confidentiality of patients an employee information in compliance with HIPPA guidelines

Minimum Education & Experience:

• High School Diploma; some college or business courses preferred

• One year of experience in a medical billing, intake, verification, and authorization environment

• Any combination of education and experience that would likely provide the required knowledge, skills, and abilities as well as possession of any required licenses or certifications is qualifying

Minimum Knowledge, Skills & Abilities

• Basic knowledge of automated accounts receivable systems
• Ability to understand and apply Medicare and Medicaid ESRD rules and regulations and coordination of benefits requirements
• Understanding of private insurance industry: PPO, HMO, POS, Marketplace/Exchange, Medicare, Advantage, Risk Plans, IPA's, and Indemnity Plans
• Ability to organize and manage a large volume of incoming documents and requests accurately with minimum supervision, as well as process ability to work independently and cooperatively with others

Requirements: The compensation for the role will depend on several factors, including the candidate's qualifications, work experience, competencies, and skills, and may fall outside of the range shown.