Insurance and Benefits Coordinator - Home Health

Overview

The Insurance and Benefits Coordinator at Elmwood Healthcare is responsible for managing all aspects of insurance verification, authorization, and billing processes to ensure efficient and timely reimbursement for home health services provided. This role requires a strong understanding of insurance policies and procedures, excellent communication skills, and the ability to work collaboratively with healthcare providers and insurance companies.

• Insurance Verification:
  Verify patients' insurance coverage and benefits prior to service initiation. Communicate coverage details, co-pays, deductibles, and out-of-pocket expenses to patients and their families.
• Authorization and Pre-certification:
  Obtain necessary authorizations and pre-certifications from insurance companies for home health services. Ensure compliance with insurance guidelines and timely submission of authorization requests.
• Billing and Claims Processing:
  Prepare and submit accurate claims to insurance companies, Medicare, Medicaid, and other payers. Monitor claim status and follow up on unpaid or denied claims. Resolve billing discrepancies and resubmit claims as necessary.
• Documentation and Record Keeping:
  Maintain comprehensive and up-to-date records of insurance verifications, authorizations, and billing activities. Ensure all documentation meets regulatory and compliance standards.
• Communication and
  
  Collaboration:
  
  Serve as a liaison between healthcare providers, patients, insurance companies, and other stakeholders. Educate patients on insurance coverage, billing processes, and financial responsibilities.
• Quality Assurance and Compliance:
  Stay current with changes in insurance regulations, policies, and procedures. Adhere to HIPAA guidelines and maintain confidentiality of patient information.

• High School Diploma or Equivalent (Required).
• Certification in Medical Billing and Coding (Preferred).
• Proven experience as an Insurance Coordinator, preferably in a home health care setting (Preferred).
• Knowledge of medical insurance policies, procedures, and billing practices.
• Familiarity with Medicare, Medicaid, and commercial insurance plans.
• Strong analytical and problem-solving skills.
• Excellent verbal and written communication skills.
• Ability to prioritize tasks and manage time effectively in a fast-paced environment.
• Proficiency in electronic medical records (EMR) and billing software.