What are the responsibilities and job description for the Insurance Verification and Utilization Review Specialist - Health Services position at Community Health & Counseling?
Insurance Verification and Utilization Review Specialist – Health Services
Job Type(s) : Full-Time
Location(s) : Bangor, Maine
Education : Associates Degree - Business or Secretarial Science
Experience : Three to Four Years
Job Description
This position will analyze patient insurances and verify eligibility and benefits and determine the primary payor for home health, mental health and hospice services. Obtain prior authorization for payment of services when required from third party payors or managed care companies and determine which payers will require ongoing authorizations, collaborating with Agency staff, patients, family members, facilities and physician. Responsible for utilization management of services, verifying authorization of services throughout patient’s care. Coordination of payor changes as well as claims denial management.
Medical Terminology and computer coursework or equivalent required. Working knowledge of medical terminology and healthcare insurance authorization processing. Computer skills including word processing and data entry required. Experience in dealing with internal and external customers in a fast-paced multi-task environment required.
Notice of Non-Discrimination
Discrimination is Against the Law
In accordance with all applicable state and federal laws and regulations cited below, Community Health and Counseling Services (CHCS) does not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity / expression, national origin, disability, age, genetic information, pay transparency, and status as a protected veteran, or any other trait that is protected under local, state or federal law in admission or access to, or treatment or employment in, its programs or activities.
