中心接待协调员
Central Intake Coordinator
我们的公司
BrightSpring Health Services
简介
中心接诊协调员与保险公司、分支机构和患者联系,以确保准确的患者人口统计信息和保险信息,包括保险验证/福利/授权,以及已使用/剩余福利的状态。
职责
- 验证资格和保险福利,包括但不限于:使用电子和电话资源确认已使用/剩余福利的状态,进行沟通,并将确定的保险计划通知给账单经理以更新系统。
- 获取预认证、授权和转诊,以确保必要服务的管理护理合规性。
- 履行通知要求。
- 与其他部门建立并维护工作关系,包括业务中心、临床协调员和分支机构运营。
- 在各种主题上为患者提供教育,包括患者权利、监管要求和财务政策。
- 准备口头/书面沟通,包括定期状态更新。
- 在计算机系统中维护所有与患者、保险公司代表和预认证的对话的文档和记录。
- 通过遵守与HIPAA、FCRA及其他适用于BrightSpring Health业务实践的法律相关的政策和程序,支持BrightSpring Health的合规计划。
- 完成所有必要的培训,保持对BrightSpring Health《道德准则》(LEGACY)的最新了解,并立即遵循与合规、事件、HIPAA相关的报告程序,并遵守保密义务。
- 与患者和保险公司保持有效的沟通策略和风格,无论是口头还是书面,以确保积极的整体内外部客户服务体验。
资格
- 需要人力资源文凭/GED;优先考虑来自认可大学的副学士学位或学士/硕士学位。
- 2年以上与商业或政府保险公司打交道的角色经验,用于验证医疗保障或对患者的覆盖费用进行账单、收款或跟进活动。
- 医疗账单证书/医疗保险专业证书优先考虑
- 强大的分析能力,以处理入院并准确及时地完成
- 能够操作基于网络的程序和Microsoft Office/包括Excel
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Our Company
BrightSpring Health Services
Overview
The Central Intake Coordinator contacts insurance companies, branch operations, and patients to ensure accurate patient demographic and insurance information including insurance verification/benefits/authorizations, and the status of a used/remaining benefits.
Responsibilities
- Verifies eligibility and insurance benefits including but not limited to: Confirming the status of used/remaining benefits using electronic and telephonic resources, communicating, and identified insurance plan to billing manager for system updates.
- Obtains pre-certification, authorizations, and referrals to ensure managed care compliance for necessary services.
- Fulfills notification requirements.
- Partners and maintains working relationship with various departments throughout the organization, including Business HUB, Clinical Coordinators and Branch Operations
- Provides patient education as needed on various topics including patient rights, regulatory requirements, and financial policies.
- Prepares oral/written communications including periodic status updates.
- Maintains documentation and notes in computer system regarding all conversations with patients, insurance company representatives, and pre-certification.
- Supports BrightSpring Health’s Compliance Program by adhering to policies and procedures pertaining to HIPAA, FCRA, and other laws applicable to BrightSpring Health’s business practices.
- Completes all required training, maintains active working knowledge of BrightSpring health’s Code of ethics (LEGACY), and immediately follows reporting procedures related to compliance, incidents, HIPAA, and adheres to confidentiality obligations.
- Maintains effective communication strategies and style with patients, insurance companies both verbally and in writing to ensure a positive overall internal/external customer service experience.
Qualifications
- HR Diploma/GED required; Preferred Associates Degree or BS/BA from accredited college.
- 2+ years of experience in a role that interfaces with commercial or government insurance payers to verify medical coverage or to perform billing, collections or follow up activities on covered charges for patients
- Medical billing certificate/ medical insurance specialty certificate preferred
- Strong analytical skills to process admissions and accurately and timely
- Demonstrated ability to navigate Web Based programs and Microsoft Office/including Excel
- Demonstrated ability to communicate effectively and to simplify complex information to all stakeholders in verbal and written form
- Ability and willingness to work cohesively in a team environment locally and across other departments and locations
- Demonstrate patience with a strong attention to detail
- Demonstrated ability to apply critical thinking skills, creativity, and a commitment to ensure that we meet the needs of stakeholders and patients.
- Minimal travel, rarely or as needed
About our Line of Business
BrightSpring Health Services provides complementary home- and community-based health solutions for complex populations in need of specialized and/or chronic care. Through the Company’s service lines, including pharmacy, home health care, and rehabilitation, we provide comprehensive and more integrated care and clinical solutions in all 50 states to over 475,000 customers, clients and patients daily. BrightSpring has consistently demonstrated strong and industry-leading quality metrics across its services lines, while improving the health and quality of life for high-need individuals and reducing overall healthcare system costs. For more information, please visit www.brightspringhealth.com. Follow us on Facebook, LinkedIn, and X.Salary Range
USD $21.00 - $24.00 / HourOriginally posted on Himalayas