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* This role can go remote in less than a year!*
Description:
The Insurance and Authorization Specialist is an Administrative support position that is considered the front line of the revenue cycle process when a patient is need of care and they need to start the insurance verification process.
The branches will put in orders for services and this person obtains benefits and insurance information, part of the ongoing authorization process to update, tracking, documentation of necessary tasks/updates to essentially get the patient coverage clearance for Home Call (LHC) home health services performed.
90% Back office high volume, fast paced administrative tasks/ 10% phone calls to follow up or answer questions
Formal Overview:
Obtains authorization from payer’s case manager for services ordered/requested for prospects/ referrals in a timely manner.
Documents specific details related to the authorization including effective and end dates using the appropriate legacy system and associated software application via patient notes, authorizations, tasks, workflow, phone calls and/or email.
Obtains additional pre-certification as needed. Consults w ith the agency as needed for all private insurance referrals and documents/communicates via the software application in a timely manner.
Serves as a liaison between the branch location and the payer on a regular basis.
Coordinates and communicates with the branch location regarding any changes or updates from the payer in a timely manner.
Accesses authorizations via email, telephone, fax, and/or on-line application in the most efficient and timely manner.
Resolves all customer requests, inquiries, and concerns in an expedient and respectful manner.
Problem solves independently before referring issues to the Supervisor/Manager for resolution.
Performs eligibility and or similar, comparable, or related duties as may be required or assigned.
About TEKsystems:
We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.