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Insurance Specialist

Company: Mission Healthcare Services Inc
Location: San Diego
Posted on: July 14, 2019

Job Description:

Are you looking for a job where you can grow, have an adjustable schedule, and have a supportive team behind you? Mission Healthcare is the company to give you that flexibility youre looking for! Mission Healthcare is a company that takes pride in putting their employees needs first. Employee happiness is key to work in a healthy harmonious environment and to ensure quality patient care.In 2018 we won The Pursuing Purpose Award, we take much pride and responsibility with receiving such an honorary award. One of our biggest motivators is to let our employees know they are making a positive difference in other peoples lives and that their jobs matter to not only the company but the rest of the world. Your voice is very important to our company. Come work for Mission Healthcare and see what Mission Healthcare can do for you!

Service Line: Healthcare

Job Title/Position: Insurance Specialist

Reports To: Director of Administrative Services

Position Description:

The Insurance Specialist is responsible for providing the highest level of customer service to both internal and external customers in a fast-paced team-oriented environment. This position manages the total referral process for non-Medicare referrals including; the referral initiation, physician, patient, and insurance verification, assignment of referrals and record keeping, as well as establishing and maintaining positive relationships with customers and referral sources. The Insurance Specialist must have excellent verbal and written communication skills, organizational and problem-solving skills, and the ability to multi-task effectively. Teamwork is a critical part of this position as the Insurance Specialist will work in partnership with multiple internal groups, including Customer Service Specialists, Marketing, Branch Clinical Operations, Clinicians, and Scheduling staff.

Duties and Responsibilities:



  • Initiates referral by accepting information from referral sources (including the use of multiple electronic referral systems) and completing referral in Homecare Homebase (HCHB) from start to finish.

  • Call physician offices to thank them for patient referral, ensure that they are following and will sign orders and ask if there is anything else we can help with.

  • Obtains verification, eligibility, and authorization of patients third-party payor, MIA, Med-Cal, Managed Care and other designated coverage as appropriate and communicated necessary information in a timely manner.

  • Screen patients to verify client address and telephone number, service needs, insurance, and if applicable, Durable Power of Attorney information.

  • Apply knowledge of Homecare, Home Health, and Hospice to be able to answer any questions the patients may have about Missions services

  • Provides information to Agency staff, the general public, patients, and payor sources, as appropriate, regarding Agency and other community services. Maintains good customer service relations and accurate and efficient communications at all times.

  • Collects, processes and transmits to Agency departments and branch offices the information necessary to support the functions of those departments/ offices as requested. Accurately documents all information into agency computer system.

  • Maintains tracking of all Managed Care patient authorizations and ensures timely notifications of branch offices, as appropriate.

  • Run monthly batch eligibility based upon assigned alphabetical group for Medicare and Non-Medicare patients.

  • Maintains current and accurate knowledge of contract insurance company needs and processes the required paperwork per specific contractual guidelines. Assists Agency and department personnel in the solution of specific issues and contact questions.

  • Verify orders and physicians and obtain specific orders for care and obtain physician UPIN number if necessary.

  • Seeks professional guidance and asks questions, as appropriate.

  • Participates in scheduled meetings and department projects.

  • Other duties as assigned, including but not limited to calling laboratory/X-ray companies to order specific tests required by the physician, informing ancillary services, such as Mission Homecare, of the needed services for the client.

    Qualifications



    • High school graduate; associates or bachelors degree preferred in health related field.

    • Knowledge of medical terminology.

    • Experience in health care related field including managed care, third-party payor billing, and/or medical office administration.

    • Computer knowledge.

    • Typing/word processing skills.

    • Customer service skills.

    • Excellent and effective communication skills.

Keywords: Mission Healthcare Services Inc, San Diego , Insurance Specialist, Other , San Diego, California

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