Claim specialist Jobs in Buffalo ny

What's in it for you? Hospice offers a Robust Total Rewards Package

Employer 401k contribution regardless of employee participation, and match on employee contributions there after

Health Insurance with vision component copayment plan, or high deductible plan (FT status)

HSA with high deductible health plan twice annual Employer contribution (FT status)

Dental Insurance (FT status)

Flexible Spending Account (FT status)

Paid Time Off PTO & NYS Sick Leave

Tuition Assistance Program

And Much More!

8 : 30am - 4 : 30pm, Monday through Friday (during training 8am-4pm)

Summary :

Responsible for coordinating the intake, scheduling, and care delivery process for patients. Conducts interviews with patients to compile intake information. Makes referrals to service providers based on patient needs and assessment. Works under the general supervision of the Admission Team Manager.

Essential Duties and Responsibilities :

Receives intake and informational calls. Directs department calls to the appropriate party; assists with phone calls to non-admitted patients to facilitate admissions.

Assists in the day to day coordination of team clinical functions, facilitates, and schedules assessments.

Obtains complete demographic and insurance information from appropriate source. Obtains medical certification and less than six-month prognosis for Hospice patients from the attending physician prior to assessment visit.

Obtains and retrieves medical information pertinent to referral, prior to nursing assessment when possible.

Notifies Team Manager or Director of scheduling concerns, documentation / insurance requirements.

Ensures nursing staff has current and accurate patient information attached to the patient chart.

Understands and applies local coverage Determination Policies in order to assist in the identification of the best system of care for the prospect and assure eligibility for Hospice.

Understands and applies Medicare, Medicaid, and third party requirements for eligibility and informs referral sources, as necessary.

Participates in verification of insurance benefits. Follows up on third party insurance authorization when necessary. Acts as resource person for insurance information to all staff. Participates in special projects, statistical reporting, and analysis, as necessary.

Demonstrates bias for action, acts on what is important, is proactive and creative, possesses a can-do attitude, ability to multi-task, has the ability to work under pressure and keep difficult situations in perspective.

Performs necessary clerical tasks to include filing, mailing, record keeping, copying, and other tasks assigned to assure professionally organized medical and statistical records and to facilitate referral processing.

Enters all patient information, telephone calls, prospect disposition into EMR System.

Non-Essential Duties and Responsibilities :

Expected to perform additional duties.

Qualifications :

Education / Certification

High School Diploma / GED preferred

Experience

Experience in a healthcare environment preferred.

Experience in Hospice & Palliative Care helpful.

Skills / Abilities :

Possess critical thinking skills, proficiency in organizing resources and establishing priorities and strong interpersonal and communication skills.

Ability to plan and meet both short and long term goals.

Working knowledge of Microsoft Office such as Word, Excel, PowerPoint, and Outlook.

Excellent oral and written communication skills.

Excellent analytical and decision making skills.

The ability and eagerness to promote a team environment by working in a cooperative and collegial manner with others to accomplish organizational goals and objectives.

Must be able to handle diverse work problems on a daily basis with the ability to resolve problems and handle conflict as part of a team.

Physical Demands :

Typical office setting. May experience eye and repetitive motion strain from work on computer.

Position requires sitting, standing, bending and reaching along with a normal range of hearing and vision.

Must be able to negotiate stairs, driveways, and other environmental objects, for off-site appointments and events.

Must be able to operate standard office equipment such as computer, mobile device, phone, copier, scanner, printer, or related items.

Environmental Conditions :

May be called upon to work beyond the normal workday and rotate weekend shifts

Must have good personal hygiene and adhere to corporate dress policy.

Job Posted by ApplicantPro