Insurance Specialist (JR233919)

<strong>To heal, to teach, to discover and to advance the health of the communities we serve.</strong>

White Plains, New York

Burke Rehabilitation

<h4 class="">Burke Rehabilitation is a nationally recognized and accredited not-for-profit healthcare provider specializing in rehabilitation treatment, research, and graduate medical education. Burke offers a full spectrum of inpatient and outpatient rehabilitation services to improve the quality of life for patients recovering from illness, injury, and chronic conditions.se.<br /><br /><span style="text-decoration: underline;"><a href="https://montefiore.wd12.myworkdayjobs.com/en-US/MMC/login" target="_blank" title="Candidate Home" rel="noopener noreferrer">Sign In</a></span>&nbsp;- Candidate Home<br /><span style="text-decoration: underline;"><a href="https://montefiore.wd12.myworkdayjobs.com/en-US/MMC/introduceYourself" target="_blank" title="Introduce Yourself " rel="noopener noreferrer">Introduce Yourself&nbsp;</a></span>-&nbsp;Please let us know about yourself so we can keep in touch about future job openings!<br /><br /><strong>Check Out Our Employee&nbsp;<span style="text-decoration: underline;"><a href="https://s3.us-east-1.amazonaws.com/data.vizirecruiter.com/Benefits-Burke.pdf" target="_blank" title="Benefits" rel="noopener noreferrer">Benefits</a></span></strong></h4> https://www.burke.org/

keywords: position summary,pay rate,communication,insurance,assist,follow-up,support,education & experience,skills

Full time

$28.00-$31.00

Overview: <p>For positions that have only a rate listed, the displayed rate is the hiring rate but could be subject to change based on shift differential, experience, education or other relevant factors.<br /><br />Responsibilities include case management for all commercial insurance, Medicare and Medicaid primarily for off-sites and OPD as needed.</p>
Responsibilities: <ul> <li>Advises patients of insurance coverage and potential out-of-pocket expenses.</li> <li>Notifies clinical departments and patient accounts when insurance will no longer cover treatment.</li> <li>Responsible for following Medicare guidelines for outpatient rehabilitation for off-sites and OPD Medicare patients.</li> <li>Responsible for tracking when Medicare patients are close to exhausting their rehabilitation benefit.</li> <li>Distributing ABNs to off-site and OPD Medicare patients when patients meet rehabilitation benefit limits.</li> <li>Responsible for following Medicaid guidelines for outpatient rehabilitation and obtaining daily authorizations for off-site and OPD Medicaid patients.</li> <li>Answer patient phone inquiries.</li> <li>Responsible for review of all Outpatient Business Office mail.</li> <li>Update Mediserve authorization file with authorizations.</li> <li>Schedules re-evaluation appointments for insurance follow-up.</li> <li>Responsible for setting up and maintaining follow-up system for case managed accounts for initial and recurring authorization requests.</li> <li>Responsible for notifying patients if their carrier has not pre-authorized OPD services and advising patients of Burke payment policies.</li> <li>Contact patients to obtain updated prescriptions if necessary.</li> <li>Contact physician offices to obtain additional updated prescriptions if necessary.</li> <li>Responsible for follow-up calls to insurance companies on pending authorizations.</li> <li>Responsible for OPD case management as needed.</li> <li>Will provide backup coverage to schedulers in OPD as needed, and the satellites on an emergency basis.</li> <li>Any other duty as directed by Manager.</li> <li>Practices universal precautions.</li> <li>Demonstrates the ability to communicate with pediatric, adolescent, young adult, and geriatric patients and visitors.</li> <li>Adheres to Service Excellence Standards by demonstrating positive communication, prompt &amp; respectful service and maintaining an appropriate work environment when working with patients, staff, co-workers, visitors and others.</li> <li>Other duties as assigned.</li> </ul>
Requirements: <ul> <li>High School Diploma or GED Required.</li> <li>3-5 years in hospital setting (preferable outpatient), billing company, multi-specialty doctor&rsquo;s office or insurance company Required.</li> <li>Individual must be computer literate, possess excellent organizational and customer service skills, detail-oriented, and able to multi-task.</li> <li>Knowledge of medical terminology is required.</li> <li>Prior experience obtaining insurance authorizations or referrals is required.</li> <li>Computer experience required, preferably working with a scheduling system.</li> <li>Able to work independently and to meet insurance authorization expiration date deadlines.</li> <li>Must be able to communicate with tact and diplomacy.</li> <li>Takes initiative and be self-directed.</li> </ul>