Entry Level Intake Specialist - Home Health

Intake and Eligibility Specialist

Job Overview:

We are seeking a detail-oriented and compassionate Intake and Eligibility Specialist to join our home healthcare team. The Intake and Eligibility Specialist will be responsible for managing the intake process for new patients, ensuring they meet eligibility requirements for services, and accurately processing insurance and billing information. This individual will collaborate with healthcare providers, patients, and insurance companies to facilitate a seamless transition into home healthcare services.

Key Responsibilities:

• Intake Coordination:
• Manage the intake process for new patients, including gathering all necessary documentation and forms.
• Conduct thorough assessments to determine patient needs and eligibility for home healthcare services.
• Ensure that all intake paperwork is completed accurately and in a timely manner.
• Serve as the primary point of contact for patients and families during the intake process.
• Eligibility Verification:
• Verify patient eligibility for insurance coverage and benefits, including Medicare, Medicaid, and private insurance plans.
• Coordinate with insurance providers and healthcare professionals to ensure all required authorizations and referrals are in place.
• Troubleshoot and resolve any eligibility or authorization issues in collaboration with insurance representatives.
• Documentation & Compliance:
• Maintain accurate, up-to-date records of patient information, insurance details, and eligibility determinations.
• Ensure compliance with all federal, state, and company regulations, including HIPAA requirements.
• Prepare and submit necessary documentation for insurance claims, authorizations, and reauthorizations.
• Collaboration:
• Work closely with clinical staff, healthcare providers, and the billing department to ensure a smooth intake process.
• Communicate effectively with patients and families to explain insurance benefits, eligibility, and services offered.
• Assist in coordinating home healthcare services based on the patient’s needs and eligibility status.
• Problem-Solving:
• Address and resolve patient and insurance issues related to eligibility and coverage.
• Provide support in managing denied claims, including gathering necessary information and submitting appeals.

Qualifications:

• Education & Experience:
• High school diploma or equivalent required; Associate’s or Bachelor’s degree in healthcare administration, medical billing, or related field preferred.
• Minimum of 2 years of experience in intake, eligibility verification, or healthcare administration, preferably in a home healthcare setting.
• Knowledge of Medicare, Medicaid, and private insurance eligibility processes.

Skills & Abilities:

• Strong understanding of healthcare insurance plans, eligibility, and authorization processes.
• Excellent organizational skills with attention to detail.
• Strong communication skills, both verbal and written.
• Ability to work independently and as part of a team.
• Proficient in MS Office Suite (Excel, Word, Outlook) and familiarity with electronic health record (EHR) systems.
• Ability to handle sensitive patient information with confidentiality and professionalism.

Work Environment:

• This role will be performed in an office setting, with occasional visits to patient homes or healthcare facilities as needed.

Compensation:

• Competitive salary based on experience.
• Benefits package including [health insurance, paid time off, retirement plan, etc.].

Job Type: Full-time

Pay: $50,000.00 - $60,000.00 per year

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Medical Specialty:

• Home Health

Schedule:

• 5x8
• Monday to Friday
• Weekends as needed

Application Question(s):

• Do you have a valid driver's license/vehicle?
• Are you willing to travel occasionally for work during office hours?

Education:

• High school or equivalent (Preferred)

Experience:

• Home health: 1 year (Preferred)
• Intake: 1 year (Required)

Ability to Commute:

• Middlebury, CT 06762 (Required)

Work Location: In person

Salary : $50,000 - $60,000