Senior Benefits Verification Associate

BAYADA Home Health Care is seeking a full time Insurance Confirmation Senior Associate in our Insurance Confirmation Home Health office. This is a remote opportunity.

The Senior Associate, Eligibility is responsible for obtaining insurance benefits and verifying insurance eligibility and home care benefits. This position will serve as a liaison between the service office providers, insurance carriers, and revenue cycle management functions. A high level of customer service and support is required to effectively communicate eligibility status. The Senior Associate will also provide mentorship and educational support to team members.

Hours: 8:30am - 5:00pm EST

Responsibilities:

• Verify eligibility and care benefit information for designated referrals, including, but not limited to deductibles, co-pays, policy limitations, exclusions, lifetime maximums, and billing addresses.
• Communicate with the appropriate service office and coordinator when insurance benefits are not adequate, when out-of-pocket expenses are high, when a policy does not require pre-certification, when a client is not eligible, or there are overall plan changes. Update files appropriately.
• Perform eligibility checks thoroughly and in a timely fashion.
• Enter plan information for all referrals not requiring a benefit confirmation.
• Reconfirm benefits for all active clients on a reoccurring and/or ad hoc basis as required.
• Collect completed payor forms from service office and send them to appropriate department/insurance to release benefit and financial info on clients as needed.
• Identify if a service office is credentialed and contracted with insurance.
• Clearly document all benefit and billing information in appropriate systems.
• Identify when insurance representatives misquote benefits and assist them in retrieving accurate information.
• Post benefit confirmations to the service offices.
• Inform collections of changes to client billing information, update bill-to numbers, and answer billing-related questions as needed.
• Complete insurance verifications to identify changes in benefit eligibility.
• Obtain eligibility documents from payors or third-party systems to substantiate billing requirements, especially for coordination of benefit procedures.
• Assist offices in relaying benefit information to clients if necessary.

Qualifications:

• Four (4) year college degree.
• Two (2) to four (4) years of relevant work experience with growing responsibilities. Minimum 1 year of benefit experience
• Prior healthcare and/or home care experience preferred.
• Proficient knowledge of insurance benefits and contracts.
• Demonstrated record of strong interpersonal skills and building relationships.
• Ability to work independently, motivate and be self-motivated, and flexible.
• Strong customer service skills and demonstrated commitment to quality in all customer encounters.
• Demonstrated record meeting and/or exceeding goal achievements.
• Proven ability to multitask and manage competing priorities.
• Good analytical skills with the ability to problem solve and exhibit good judgement
• Must have Managed Medicare and Managed Medicaid experience
• Superb customer service and telephone skills
• "All hands-on deck" attitude
• Overall professional demeanor and presentation
• Strong PC skills
• Alignment with our core values of compassion, excellence, and reliability

Base Pay: $24.00-27.00 per hour depending on qualifications