Insurance Authorization and Verification Specialist

Overview

The VNA of the Treasure Coast provides compassionate, innovative care of the highest quality, setting the standard for patients and caregivers needing private care, home health, hospice, and community health services.

Together, we provide the highest quality patient care.

Come be a part of the VNA team! We are a mission-minded non-profit organization that has been committed to making a difference in the community we serve since 1975!

The VNA offers its associates a competitive array of benefits and perks such as:

• Competitive pay 
• Up to 18 paid days off accrued in first year, 6 observed holidays*
• Competitive rates and plans for health, dental, and vision insurance*
• Employer paid term life insurance*
• 403b retirement plan with company match after one year
• Complimentary access to VNA Mobile Health Clinic
• Tuition reimbursement after one year of service*
• Free CEU credits
• Immediate Access to Employee Assistance Plan (EAP)
• Several local and national discounts

*Available to benefit eligible associates

The VNA is seeking a full time authorization and Verification Specialist. The primary responsibilities for this position are to verify insurance benefits and obtain authorization for services. Document information in billing/clinical system for clinicians to inform patients. Introduce needs assessment to eligible patients/representatives for charitable care and/or patient assistance. Prepare Medicare Secondary Payer documentation when applicable. Demonstrate a professional, courteous manner that integrates the VNA Core Values in all aspects of duties and responsibilities.

Responsibilities

• Obtain, monitor, and update patients' insurance information to ensure accurate billing and timely collection of accounts receivable.
• Document insurance coverage including co-pay in billing/clinical system.
• Maintain accurate payer source file for all patients to enable the workflow into billing and accounts receivable. 
• Verify Medicare information by reviewing electronic eligibility for alerts. 
• Scan/upload and /organize patient referral documentation into the billing/clinical system.
• Obtain insurance pre-authorization following department procedures; document data and outcome in the billing clinical system.  Submit accurate documentation to payer source as required and in conjunction with clinical supervisor for services authorization. 
• Review patient intake information for Medicare secondary payer identification and complete Medicare secondary payer information as required. 
• Follow VNA policies with patients who have no insurance; assist individuals in completing the Needs Assessment Application for charity or indigent care; coordinate with the Social Worker and Case Manager as needed.
• Forward documentation to Patient Account Manager for approval.  Communicate with potential patient, their representative, the Social Worker and/or Case Manager when needed to obtain additional information or about the application status.
• Interact daily with Patient Care Managers, Medical Records and Referral Center staff when obtaining, updating, documenting and authorizing patient insurance coverage. Work with scheduling staff to ensure authorizations are obtained in a timely and complete manner. 
• Communicate issues, problems or concerns to Lead Authorization and Verification Specialist for timely resolution and share information with co-workers to promote continuous learning.
• Provide input on policies, procedures and processes in order to enhance and improve department efficiencies in workflow, communication, and service.
• Prepare and/or assist with department reports or projects as requested.
• Participate in meetings and committees as needed.  

Qualifications

Associate Degree or equivalent from a two-year college or technical school desired.  One year related experience, training, or equivalent combination of education and experience.  Familiar with medical terminology a plus. 

#indspn