Job Summary:
The Insurance Coordinator is responsible for ensuring prompt and efficient handling of insurance and related documents in order to receive payment in a timely manner for inpatient rehab services. This is accomplished by following up with insurance companies (government and non-government) as well as identifying and resolving problems. In performance of these duties, this role is responsible for and includes, but is not limited to the following:
- Communicating with patient/caregivers prior to admission to IRF to explain insurance pre-authorization process, discuss insurance beneifits, etc.
- Monitoring all referral calls concerning prospective patients, verifying insurance benefits and initiating pre-authorization for inpatient rehab prior to admission.
- Filing of insurance, follow-up on insurance claim edits, and referral of accounts for special handling and ensuring updates to patient accounts notes in the EMR are documented with appropriate detail.
- Initiating prior authorization for IRF patients as needed for surgical/procedures
- Maintain departmental reports/spreadsheets, prepare reports for monthly team meetings, and correspondence with referral source concerning patients and/or payers.
- Assisting with all other duties as assigned.
- This position requires an individual who can work with a minimum of supervision. Demonstrates knowledge and skills to appropriately communicate and interact with the patients, families, and visitors of all age groups while begin sensitive to their cultural and religious beliefs.
Performance Expectations:
Performance Expectations that are job specific will be covered during your department orientation. You will be assessed for your competency of these expectations during your first 90 days of employment
- Demonstrates competence in basic computer skills
- Performs accurate record keeping and ensures the confidentiality of information, medical records, financial statement, and staff and legal information.
- Verifies Insurance information and obtains a copy of the insurance card when appropriate
- Monitors/communicates plan or coverage limits if known.
- Monitors and processes concurrent visit requests when appropriate
- Responsible for processing all assigned bill error claims on a daily basis.
- Notates accounts in Epic fully on each account and attaches all required supplemental documentation to primary and secondary claims 100% of the time to ensure proper adjudication and prevent claim denials.
- Obtains and inputs all necessary information from Physicians orders required by payer and verifies that information is entered correctly
- Demonstrates effective time management skills
- Demonstrates understanding of HIPPA and obtains signatures on privacy and consent forms prior to completing registration.
- Consistently communicates in a friendly, courteous manner in all interactions with patients, families, visitors and employees while achieving patient satisfaction, loyalty and confidentiality.
- Understands and abides by regulating bodies such as CMS, CARF, DNV or other policy guidelines pertaining to admission, discharge or financial matters
- Accesses assigned payer website accounts or links daily to prevent password inactivation
- Maintains a working knowledge of IRF Admissions and continued stay processes as well as processes for obtaining medical equipment to ensure patients’ needs are met throughout the continuum of care.
- Perform other assigned duties as needed
Qualifications:
Education/Skills
High school diploma or equivalent required.
Work Experience:
Experience operating personal computer/calculator accurately is required.
A minimum of 1 year insurance follow-up or billing experience is required.
Experience with Microsoft Excel is preferred.
Certification/Licensure:
None
Mental Demands:
Numerical ability is required to calculate and check insurance billings. Verbal ability is required to interpret and explain Medicare/Medicaid/Managed Care/Commercial Insurance payment policies and procedures. Must have the ability to communicate effectively.
Work Location:
This role is an in-office work position. Ample workspace will be provided by FGH for office work.
