What are the responsibilities and job description for the Insurance and Authorizations Manager for Home Health Care position at Village Home Care, LLC?
Position Overview:
We are seeking a detail-oriented and proactive Authorization Specialist to join our team. This role is crucial in ensuring accurate and timely billing processes by verifying eligibility, authorizations, and client account information. The ideal candidate will be responsible for submitting claims, following up on unpaid or rejected claims, and ensuring all billing information is complete and correct. The Authorization Specialist will also collaborate with insurance companies, patients, and internal teams to resolve issues and ensure smooth processing of claims.
Key Responsibilities:
- Perform eligibility verification and authorizations to ensure clean claims are billed.
- Submit claims daily and monitor for timely processing.
- Follow up with insurance companies on unpaid or rejected claims, resolving issues and re-submitting claims as needed.
- Enter daily information into EMR systems, documenting attempts to resolve payment or claim issues.
- Manage the appeals process, ensuring timeliness and adherence to payer-specific procedures.
- Complete processes related to the Medicare Cost Report on time and as directed.
- Obtain claims addresses and insurance company identification for new providers and promptly notify the billing supervisor of any updates.
- Understand managed care authorizations and limits to coverage, such as visit limits, and apply that knowledge to claims management.
- Download payment reports from appropriate portals, clearinghouses, and EOBs.
- Process specific adjustments, reason codes, and balances after each EOB.
- Identify and correct posting errors as they occur to ensure accuracy.
- Resolve patient complaints regarding insurance coverage and services.
- Work with patients to establish payment plans for past-due accounts.
- Process payments and refunds in accordance with the guidance of the Patient Account Manager.
- Prepare and present reports on collection activities and progress.
- Perform miscellaneous job-related duties as assigned.
Qualifications:
- Strong understanding of healthcare billing, insurance verification, and authorization processes.
- Experience with managed care, Medicare, and Medicaid billing preferred.
- Familiarity with EMR systems and claims submission processes.
- Excellent communication and problem-solving skills.
- Ability to manage multiple tasks in a fast-paced environment.
- Detail-oriented and organized with the ability to work independently and as part of a team.
If you're a highly motivated individual with a passion for ensuring smooth billing processes and customer satisfaction, we'd love to hear from you! Apply today to join our dynamic team
Job Types: Full-time, Part-time
Pay: $18.00 - $20.00 per hour
Benefits:
- Dental insurance
- Health insurance
- Paid time off
Schedule:
- 4 hour shift
- 8 hour shift
- Day shift
Education:
- High school or equivalent (Preferred)
Experience:
- Home Health Care: 1 year (Preferred)
- authorization: 5 years (Preferred)
Work Location: In person
Salary : $18 - $20
