Home Healthcare Financial Services Representative

General Purpose

Responsible for various financial services processes to support authorization and payroll.

Essential Functions

• Verifies insurance coverage for potential new patients and re-verifies insurance coverage for existing patients.
• Reviews requests for authorization needed based upon insurance standards while drawing upon experience and general knowledge.
• Reviews documentation or contacts the provider when necessary to supplement the order to prove medical necessity.
• Handles calls related to client benefit eligibility verification and authorization requests.
• Maintains up to date information on assigned insurance companies. Documents and communicates relevant changes to appropriate staff.
• Ensures appropriate documentation is available and complete before submitting the authorization to the insurance company to avoid repetitious submissions and denials.
• Submits all authorizations with correct diagnosis codes.
• Enters any authorization numbers and expiration dates into the system as required for appropriate tracking.
• Supports payroll processing. Matches timesheets to verify visits in the system. Notes discrepancies and review with Supervisor to ensure accurate payroll administration.
• Provides reports and information to others as needed to support billing and payroll activities.
• Complete all assigned tasks with a high degree of accuracy and within allotted timeframe.
• Performs other assignments as requested.
• May have access to personal health information (“PHI”) necessary to fulfill the above duties and responsibilities. Access to use and ability to disclose PHI is further defined by each organization/department.

Minimum Education & Experience Requirements

• High school diploma. Associates degree, preferred.
• Two (2) years relevant office experience, preferably in the healthcare industry.
• Or an equivalent combination of experience and education.

Knowledge, Skills & Abilities Required

• The ideal candidate will be detail oriented, highly organized and thrive in a team environment.
• Microsoft Office experience and Intermediate Excel skills are a plus.
• Strong written and verbal communication skills.
• Familiarity with Google docs and Google apps.
• Understanding of insurance websites and form fields for authorization submission highly preferred.

Working Conditions & Physical Effort

• Work is normally performed in a typical interior/office work environment.
• Physical activity is sedentary and may require occasional lifting or carrying up to 10 lbs.
• Ability to sit in front of a computer for long periods of time.

Key

Occasionally

Activity/conditions exist 0-2.5 hrs/day or up to 30%

Frequently

Activity/conditions exist 2.5–5.5 hrs/day or over 30%

Constantly

Activity/conditions exist 5.5+ hrs/day or over 60%

Sedentary

Lifting/carrying up to 10 lbs

Light

Lifting/carrying/pushing/pulling up to 20 lbs

Medium

Lifting/carrying/pushing/pulling up to 50 lbs

Heavy

Lifting/carrying/pushing/pulling over 50 lbs

Very Heavy

Lifting/carrying/pushing/pulling over 100 lbs