Job Summary
The Visiting Nurse Association of Utica & Oneida County’s (VNA) Intake Coordinator / Insurance Authorization Specialist is responsible for the daily operational aspects of the referral process by relaying information to the appropriate internal and external affiliates and community agencies, and acts as a liaison between the Clinical Department and the insurer to ensure that authorizations to bill for services have been obtained.
This person also acts as a resource and provides technical support to the Clinical Reviewer and Support Staff Supervisor.
Core Job Responsibilities
Strong working knowledge of Home Care Services (VNA / Senior Network Health (SNH) / Mohawk Valley Home Care (MVHC) and community resources (i.
e.; MOW, Life Line, etc.).
- Functions as a resource to internal and external referral services and providers in the community.
- Obtains patient referrals from the Intake Department.
- Obtains initial insurance authorizations and documents the status in the Electronic Medical Record (EMR).
- Enters referral information into the EMR.
- Knowledgeable of the call center processes / equipment and able to mentor / develop new staff in the daily operations of the department.
- Knowledgeable of call center and insurance regulation documentation requirements.
- Coordinates the caller’s information needs and ensures referrals are being completed in a timely manner.
- Understands and supports referral information flow to ensure referrals and initial insurance authorization are being completed in a timely manner.
- Contacts patient’s insurance carrier to determine eligibility, obtain initial authorization for services, or to request any additional authorizations.
- Check work flow for additional service authorizations that may be necessary.
Education / Experience Requirements
High School diploma with a minimum of 1 to 3 years medical office / customer service experience.
Licensure / Certification Requirements
N / A
Disclaimer
Qualified applicants will receive consideration for employment without regard to their age, race, religion, national origin, ethnicity, age, gender (including pregnancy, childbirth, et al), sexual orientation, gender identity or expression, protected veteran status, or disability.
Successful candidates might be required to undergo a background verification with an external vendor.
Job Details
Req Id 90650
Department CALL CENTER
Shift Days
Shift Hours Worked 7.50
FTE 0.94
Work Schedule HRLY NON-UNION-LONG TERM CARE
Employee Status A1 - Full-Time
Union Non-Union
Pay Range $ - $ Hourly
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