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Insurance Specialist - Must live in Texas

Remote, USA Full-time Posted 2025-04-26

Job Description

JOB TITLE: Insurance Specialist

REPORTS TO: Director of Billing and Authorizations

JOB OVERVIEW: Insurance Specialist is a qualified individual who will perform a variety of administrative functions related to quote of benefits and coordination with the parent, Patient Services Specialists and Authorizations team, in the corporate office of a Home Health Care Agency.

    ESSENTIAL FUNCTIONS INCLUDE BUT ARE NOT LIMITED TO:
  • Knowledgeable about specific payers and processes efits in a skilled and timely manner.
  • Knowledgeable about specific payers and processes
  • Self–Directed; needs minimal supervision
  • Maintains a positive and professional attitude at all times.
  • Demonstrates excellent customer service skills with both internal and external customers
  • Exhibits excellent communication skills. Is able to clearly and concisely explain complex information.
  • Solutions oriented
  • Verifies patient insurance eligibility and benefits. May assist in obtaining and managing Insurance AUTHORIZATIONS, as needed.
  • Contacts parent/Caregiver to discuss QOB, financial responsibility and payment options
  • Uses multiple computer applications to manage and maintain medical records, verify insurance eligibility and communicate with patient caregivers as well as other teams within the agency.
  • Scans documents into the electronic medical record as necessary.
  • Works independently to identify appropriate next steps following communication with caregiver.
  • Demonstrate Critical Thinking and Problem Solving related to coordinating Insurance Criteria and Division Criteria for patient admissions and communications.
  • Maintain a clean and organized office environment at all times.
  • Be flexible and able to perform a wide variety of administrative support functions as directed
  • Performs all duties in compliance with agency policies and procedures.
  • High School graduate, some college course work-preferred.
  • Ability to multi-task with above average organizational skills-required.
  • Excellent administrative, organizational, and phone skills-required.
  • Strong Working knowledge of MS Word, MS Excel, and Outlook-required.
  • Experience in medical insurance, intake department, or authorizations, in-take department, or doctor’s office-preferred.

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