Coordinator, Precertification - Home Care, Administration - Full Time (Vestal)

Summary :

Under general supervision, to perform a variety of routine to moderately difficult office support activities, which may include recordkeeping, working in online portals, processing forms, report preparation, typing, and filing; and functioning as a positive and cooperative team member.

Experience :

1 year of applicable cumulative job specific experience required.

• Note : Required professional licensure / certification can be used in lieu of education or experience, if applicable.

Education :

High School diploma equivalency

Essential Functions :

Coordinates with Home care, clinical staff and insurance companies in obtaining authorization for all home health and hospice admissions.

Responsibilities :

Obtains authorization on for admissions as required by health plans.

Enter patient insurance authorizations and any pertinent information from insurance company into the patient account history.

Documents insurance coverage of services to be provided.

Notifies case management about interactions with insurance companies regarding services.

Communicate with clinical staff to coordinate appropriate staff visits.

Communicates any changes in insurance coverage with office and clinical staff.

Manage denials or potential denials as described by the insurer.

Monitors and reviews the applicable schedule to ensure that authorization and initial length of stay is obtained and on file.

Proficiency in online portals, and good computer skills.

Must have excellent communication skills.

Other Duties :

Required : Other duties as assigned

Pay Range $17.00 - $25.34 / hour, DOE