Home / Insurance Validation Representative (Full Time/ Day Shift)

Insurance Validation Representative (Full Time/ Day Shift)


Company

Horizon Healthcare

Cost Center

3300 HHS Administration

Supervisory Organization

Intake/Patient Account Services

Grade

G07

Summary

POSITION SUMMARY:  

To ensure patient benefits are confirmed accurately so patient can make an educated financial decision prior to beginning home infusion therapy.  Provides complete and accurate financial estimates to hospital staff, Horizon Liaisons and Patient.  Communicates information timely in order to meet all necessary time frames.  Manage the communication from the numerous hospitals so no referrals are lost.

ESSENTIAL FUNCTIONS: Qualified individuals must have the ability (with or without reasonable accommodation) to perform the following duties:

  • Serves as the primary point of contact between the liaisons/ owner hospitals/ and other referrals to ensure accurate insurance verification for requested services
  • Identifies and resolves customer registration issues including but not limited to, charge inquires, insurance inquiries, ICD10 coding and patient status changes
  • Handles escalated referral issues in a professional manner, when necessary
  • Ability to independently resolves issues
  • Effective communication within all departments  in HHS and referrals sources
  • Informs supervisor or manager of any problems or issues
  • Enter referrals accurately and within allocated time
  • Initiates initial authorization, re-authorizations when necessary to assist/cover the Authorization department.

SECONDARY FUNCTIONS: The following duties are considered secondary to the primary duties listed above

  • Helps foster an environment of continuous improvement and positivity by suggesting ideas to leadership.
  • Other duties as assigned.

JOB REQUIREMENTS

MINIMUM REQUIRED QUALIFICATIONS:

  • High school diploma or equivalent.
  • Two (2) years of clerical, customer service, or administrative support experience in a highly customer-oriented organization.
  • Strong written and verbal communication and organization skills.
  • Excellent computer skills including Microsoft Office Products.
  • Ability to apply strong analytical qualities.

PREFERRED QUALIFICATIONS:

  • Prior experience in accounts receivable and collections, preferably in the home health medical field.
  • Two (2) years of registration experience, point of service collection, insurance validation, understanding of compliance /regulatory guidelines and order release process(es).

Disclaimer: This job description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills, efforts, or working conditions associated with the job.  It is intended to be a reflection of those principal job elements essential for recruitment and selection, for making fair job evaluations, and for establishing performance standards.  The percentages of time spent performing job duties are estimates, and should not be considered absolute.  The incumbent shall perform all other functions and/or be cross-trained as shall be determined at the sole discretion of management, who has the right to amend, modify, or terminate this job in part or in whole.  Incumbent must be able to perform all job functions safely.

Disclaimer

PENN MEDICINE LANCASTER GENERAL HEALTH is an Equal Opportunity Employer, committed to hiring a diverse workforce. All openings will be filled based on qualifications without regard to race, color, sex, sexual orientation, gender identity, national origin, marital status, veteran status, disability, age, religion or any other classification protected by law.

 

Search Firm Representatives please read carefully: PENN MEDICINE LANCASTER GENERAL HEALTH is not seeking assistance or accepting unsolicited resumes from search firms for this employment opportunity. Regardless of past practice, all resumes submitted by search firms to any employee at PENN MEDICINE LANCASTER GENERAL HEALTH via-email, the Internet or directly to hiring managers at Penn Medicine Lancaster General Health in any form without a valid written search agreement in place for that position will be deemed the sole property of PENN MEDICINE LANCASTER GENERAL HEALTH, and no fee will be paid in the event the candidate is hired by PENN MEDICINE LANCASTER GENERAL HEALTH as a result of the referral or through other means.

BURLE Full Time Posted on 10/14/2022