Healthcare Insurance Eligibility Specialist Position Available In [Unknown county], Georgia

Healthcare Insurance Eligibility Specialist
Available in 3 locations
Available in 3 locations

Remote Job:

Remote Job:

Yes
widget:
Full time
undefined:
CenterWell Home Health

Job ID:

R-370844

Associated with 2 categories
Associated with 2 categories Description
Be a part of our caringmunity and help us put health first
The Eligibility Specialist role reviews insurance eligibility for patients referred for Home Health services. The role is fast-paced, requires attention to detail, and knowledge of Medicare, Medicare Advantage, Medicaid, and Commercial insurances.
As a Healthcare Insurance Eligibility Specialist, you will:
Verify patient eligibility and payor coverage guidelines to ensure that all necessary information is secured for timely, accurate revenue recognition
Weeklymunication with site leadership detailing outstanding documentation or other issues resulting in a potential loss of revenue.
Prepare, submit and follow up on eligibility requests according to applicable state andmercial payor guidelines.
Coordinate, review, and analyze documentation and data entry supporting Medicare, Medicaid, andmercial payer requirements to ensure accurate and timely billing
Ensure all internal controls and related policies/procedures are implemented and followed in accordance to the accounts receivable requirements.
Ensure all payer requirements are met accordingly, including pre-cert requirements, notification requirements, and level of care change required documents.
Alerts appropriate team members at the Site regarding late or missing documents required for billing.
Establish and maintain positive working relationships with Sites, Nursing Home Facilities, and AR Teams.
Maintain the confidentiality of patient/client and agency information at all times.
Maintain accurate and up to date information for all vendor and nursing facility contracts.
Keep information in an orderly manner readily accessible for review. Presents status as requested.
Assure forpliance with local, state and federal laws, Medicare regulations, and establishedpany policies and procedures
Participate in special projects and performs other duties as assigned.
Assist with training of newly-hired associates, as well as re-education of revenue teams as necessary.
Act as an information resource for any hard revenue generation issues or system issues. Basically the subject matter expert.
Assure thepletion and coordination of work in an associate’s absence, or as needed to maintain departmental standards.
Use your skills to make an impact

Required Experience/Skills:

One to two years related experience and/or training preferred.
Two years Home Health care or Medical Office experience preferred.
Knowledge of insurance eligibility process preferred.
Skilled in the use ofputers and the Microsoft Office applications. HomeCare HomeBase (HCHB) system experience preferred.
Two years college preferred.

Additional Information:

To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:
At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.
Satellite, cellular and microwave connection can be used only if approved by leadership.
Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
Home or Hybrid Home/Office employees will be provided with telephone equipment appropriate to meet the business requirements for their position/job.
Work from a dedicated space lacking ongoing interruptions to protect member

PHI / HIPAA

information.
CenterWell Home Health offers a variety of benefits to promote the best health and well-being of our employees and their families. Ourpetitive and flexible benefits surround you with support the same way you do for our patients and members, including:
Health benefits effective day 1
Paid time off, holidays, and jury duty pay
Recognition pay
401(k) retirement savings plan with employer match
Tuition assistance
Scholarships for eligible dependents
Caregiver leave
Employee charity matching program
Network Resource Groups (NRGs)
Career development opportunities
Scheduled Weekly Hours
32
Pay Range
Thepensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$44,900 – $60,200 per year
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offerspetitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off,pany and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About us

About CenterWell Home Health:

CenterWell Home Health specializes in personalized,prehensive home care for patients managing a chronic condition or recovering from injury, illness, surgery or hospitalization. Our care teams include nurses, physical therapists, occupational therapists, speech-language pathologists, home health aides, and medical social workers – all working together to help patients rehabilitate, recover and regain their independence so they can live healthier and happier lives.
About CenterWell, a

Humanapany:

CenterWell creates experiences that put patients at the center. As the nation’s largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (

NYSE:

HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who aremitted to putting health first – for our teammates, patients,munities andpany. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one.
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms ofpensation and selection for training, including apprenticeship, at all levels of employment.
Request an Amodation
If you are an individual with a disability and require a reasonable amodation toplete any part of the application process, or are limited in the ability or unable to access or use this online application process and need an alternative method for ing, you may contact ADAhumana for assistance.
Employment Fraud Notice
Humana will never ask a candidate for money for work equipment and network access or request access to personal accounts during the application process. Learn more about identifying and preventing employment fraud or report a suspected employment fraud case.
California Resident Applicants
If you are a California resident ing for a position and would like to review our California Applicant Privacy Policy, click : CA Resident Applicant Privacy Policy
Hide map
map is loading
At Humana, caring is everything
And when you work , you feel it. It’s how you grow. It’s how you’re weed into the associatemunity. It’s what guides us in putting health first. And it forms the connection each of us have for the people we serve.
Learn more about our culture of caring Get notified for similar jobs
Sign up to receive job alerts
Email address
required
Review and agree to the terms of processing personal information
Submit
Manage Alerts
Get tailored job rmendations based on your interests
Get started