Demo

Insurance Authorization Coordinator - Home Health

BJC
Saint Louis, MO Full Time
POSTED ON 1/21/2025
AVAILABLE BEFORE 5/22/2025
Additional Information About the Role

Schedule

  • Full time
  • Monday-Friday
  • Weekend rotation

Location

  • Remote

Overview

BJC Home Care offers patients and their families a complete range of home care services, including skilled nursing services, adult and pediatric hospice and supportive care, rehabilitation therapy, home infusion therapy, infusion treatment rooms, home medical equipment and high-tech respiratory care. Specialty home care programs also are available, including adult and pediatric asthma, cardiac, diabetes, orthopedic and wound care programs.


BJC Home Care provides care to thousands of patients in both Missouri and Illinois. Serving more than 25 counties, it has become the largest home care network in the region and one of the largest in the country.

 

 

The Central Referral Center (CRC) for BJC Home Care Services is where the patient referral process starts. There are Intake Coordinators in each BJC hospital who coordinate services for those patients that need home care. The patients who choose BJC Home Care Services are then channeled through the CRC. The CRC also consists of nurses who take physician office referrals for patients not currently hospitalized. There is someone on-call 24/7 for the CRC to facilitate home care coordination for patients in emergency rooms, etc.


Preferred Qualifications

Role Purpose

The Insurance Authorization Coordinator is responsible for ensuring that the organization has the appropriate insurance benefit, pre-certification and pre-authorization information for patients prior to the provision of care.

 

Responsibilities

  • Utilizes multiple platforms and/or vendor-based applications to investigate and determine benefits, pre-certification, and pre-authorization status.
  • Communicates with insurance companies and patients regarding benefit, pre-certification, and pre-authorization requirements and status to ensure appropriate insurance authorization is secured prior to service.
  • Answers phone calls and directs issues to the appropriate person for resolution; verifies the receipt of patient insurance authorizations and ensures that all authorizations stay current.
  • Provides assistance to the clerical and clinical team regarding the requirements for benefits, pre-authorization and re-authorization for patients.
  • Communicates benefit and/or authorization issues in a timely manner to all staff; ensures that patient care is not delayed.
  • Performs accurate and timely entry of benefit information into the patient chart.
  • Understands, monitors, and completes all work queues regarding authorizations and/or benefits, per the request of the Lead Coordinator.
  • Minimum Requirements

    Education

  • High School Diploma or GED
  • Experience

  • <2 years
  • Preferred Requirements

    Education

  • Associate's Degree
  • Supervisor Experience

  • No Experience

  • Benefits and Legal Statement

    BJC Total Rewards

    At BJC we’re committed to providing you and your family with benefits and resources to help you manage your physical, emotional, social and financial well-being.

    • Comprehensive medical, dental, vison, life insurance, and legal services available first day of the month after hire date
    • Disability insurance* paid for by BJC
    • Pension Plan*/403(b) Plan funded by BJC
    • 401(k) plan with BJC match
    • Tuition Assistance available on first day
    • BJC Institute for Learning and Development
    • Health Care and Dependent Care Flexible Spending Accounts
    • Paid Time Off benefit combines vacation, sick days, holidays and personal time
    • Adoption assistance

    To learn more, go to www.bjctotalrewards.com/Benefits

    *Not all benefits apply to all jobs

    The above information on this description has been designed to indicate the general nature and level of work performed by employees in this position. It is not designed to contain or be interpreted as an exhaustive list of all responsibilities, duties and qualifications required of employees assigned to this job. Equal Opportunity Employer

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