Lakes Region Visiting Nurse Association Hiring for Eligibility and Authorization Specialist at Remote Full Time

Overview & Qualifications

The Insurance and Prior Authorization Specialist acts as the primary source of payer information between the admin and field staff. He/she will be responsible for performing all tasks regarding patient insurance verification and obtaining prior authorizations from payers when required. This position requires a relatively high degree of written and verbal communication skills with the ability to collaborate with a highly skilled team.

· Education: High School Diploma or GED required, Billing/Coding certification/experience (preferred)

· Knowledge of Medical Billing and terminology

· Experience in Home Health/Hospice (preferred) or other medical office

· Computer Skills: Excel, Microsoft Teams, Patient EMR (Matrixcare experience will gain higher priority)

· The ideal candidate will be a problem-solver with strong organizational skills, pays attention to detail and demonstrates good time management.

Responsibilities

· Manages daily work queues to ensure eligibility is accurately verified for primary payer, co-pay, deductible, prior authorization requirements, etc.

· Obtain initial and ongoing authorizations according to company procedures, payer policies, and contract stipulations

· Be able to meticulously document and communicate the scope of each client’s eligibility and authorization requirements

. Performs a routine review of appropriate workflows and redirect workflows as needed.

· Attend periodic and monthly meetings

· Occasionally be on-call at least one weekend out of the month.

Job Type: Full-time

Pay: $20.00 – $25.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Health insurance
• Life insurance
• Paid time off
• Tuition reimbursement
• Vision insurance
• Work from home

Schedule:

• Monday to Friday

Experience:

• Insurance verification: 2 years (Preferred)
• Medical billing: 2 years (Preferred)

Work Location: Remote