Job description

Building Name: HHH - Home Health & Hospice

Location Address: 1110 Prim Rd, Colchester Vermont

Regular

Department: HHH - Revenue Cycle

Full Time

Standard Hours: 40

Shift: Day-8Hr

Primary Shift: TBD

Weekend Needs: None

Salary Range: Min/Hour $16.23 Mid/Hour $19.95 Max/Hour $23.66

Recruiter: Abby Luck

This position is fully remote - in state or out of state.

POSITION SUMMARY:
The AR Insurance Specialist has an expectation of accountability and productivity for work performed, and allows for independent action and functioning. Assigned duties are generally of a more complex technical/professional level.
Duties are generally of a complex technical/professional level. The position assists with more complex system planning, coordination and troubleshooting functions as they pertain to clinical staff, billing staff and insurance companies. Work is performed under the supervision of a Manager and requires significant interaction with other divisions, department staff, and outside service providers.

MINIMUM QUALIFICATION STANDARDS: I. Education:
Associate’s Degree

II. Experience:

• Minimum combination of education and experience from which comparable knowledge and skills are acquired.
• Background in clerical or technical experience

PERFORMANCE REQUIREMENTS:
I. Performance Standards:

• Build and maintain the patient record in Horizon. This includes: Opening episodes in Horizon, verifying and entering patient demographics including address date of birth, phone number, directions, allergies, medications
• Verify insurance benefit information for all types of referrals
• Obtain and document Pre-authorizations for all third party insurances
• Be a resource for all staff and patients for insurance questions and information
• Oversee the system for tracking authorizations, PCP referrals, Medicaid eligibility and insurance denial letters
• Be a liaison between Insurance Companies, their case managers and the University of Vermont Health Network Home Health & Hospice staff.
• Mail consent paperwork to DPOAs
• Verify MD licensure
• Add new Physician data file in Horizon
• Process certain types of referrals as designated by RN Staff/Intake Manager
• Other duties as assigned by Intake Manager
• Track and provide procedures for all new changes of processes related to Insurance processes
• Obtain Vermont Respite House insurance benefit information
• Develop in-depth knowledge of insurance companies’ benefits
• Able to recognize when nursing input is needed
• Previous experience as a Level I Intake Insurance Specialist
• Familiarity with moderately complex manual and automating filing and records systems
• Analytical and problem solving skills
• Medical Terminology, Billing and/or insurance experience desirable
• Weekend Support Staff Role involves:

a) Process referrals, enter medications with supervision from Weekend Coordinator
b) Able to navigate UVMMC PRISM system efficiently.
c) Monitor the Heads Up board for potential discharges on weekend
d) Act as a weekend information resource for weekend coordinator in order to complete their tasks efficiently
e) Working knowledge of the Electronic scheduling function as needed.
f) Order office Supplies as needed

II. Professional Accountability:

• Demonstrates a commitment to the mission and values of the organization
• Complies with all organization policies and procedures
• Demonstrates respectful and effective communication in all interactions
• Protects the privacy and confidentiality of clients, co-workers and organization’s operations
• Complies with organization’s policies to protect confidentiality, integrity, availability and security of all protected health information
• Organization’s security official
• Conducts him/herself in a safe manner by adhering to all safety practices, rules and standards
• Demonstrates a commitment to quality and proactively seeks to make improvements to systems and processes
• Reports to work on time, provides advance notice for time off, accurately reports time and attendance and appropriately manages paid time off (if applicable) in accordance with organization’s policy
• Demonstrates a commitment to integrity in work habits and use of organization’s resources
• Performs duties as assigned that may be outside his/her principle responsibilities
• Meets own learning needs. Participates in educational programs of the organization, including completion of all mandatory competencies, education or training
• Effectively communicates to transfer information, provide guidance and resolve conflicts
• Reports concerns and complaints regarding abuse, neglect and exploitation in accordance with Vermont State Law and the organization
• Enhance or improve organization’s services by participating in team meetings, projects and committees
• Contributes to a positive work environment and responds in a constructive manner to change
• Documents the provision care and services in accordance to organization’s policy

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