Billing Insurance Verification/Authorization Clerk

Sunglo Home Health Services, Inc. is seeking a Medical Billing Authorization Clerk with experience in Insurance Verification and A/R. We are looking for someone who is eager to learn in a growing company. We offer a competitive salary and opportunities for advancement within the company.
Essential Job Functions:

• Identify and document all patient accounts accurately based on what type of insurance product the patient has, PPO, HMO, other Managed Care Organizations, Medicare Advantage Plans, Government plans or Workman Compensation policies.
• Perform detailed, accurate and timely insurance verifications for patients seeking treatment.
• Protect confidential patient health information (PHI) at all stages of the verification of benefits process
• Accurately complete all data entry necessary, including patient demographics, insurance information and benefit details.
• Confirm pre-authorization requirements, submit available medical documentation and document authorization approvals or denials.
• Document insurance benefits, co-payments, deductibles and self-pay portions in the account to allow for collections due.
• Track tasks, review reports for accuracy and completeness, prepare and send insurance benefit verification results to designated departments on deadline.
• Call patients at their home, etc. to obtain any additional demographic or insurance related information that may prevent completion of assigned verification tasks.
• Review claims for accuracy prior to billing and bill commercial, Medicare, PIP and Comp claims to insurance carriers weekly.
• Analyze AR accounts greater than 31 days outstanding and initiate collections.
• Timely follow-up on claims and appeal payments/denials when required.
• Escalate payor issue trends for leadership consideration along with possible solutions.
• Assist and resolve efforts for payers other than those assigned.
• Consistently follow internal processes as well as meet or exceed monthly quality and productivity standards

Qualifications:

• High school level diploma or GED required
• At least 2-5 years of medical billing & Insurance verification experience. Home Care billing experience is highly preferred but not required.
• Proficiency in MS Word and Excel required.
• Basic level mathematical proficiency, with a strong ability to understand, interpret, calculate and communicate financial responsibility.
• Advanced knowledge of In-Network and Out-of-Network health insurance processing.
• Ability to meet critical deadlines.

Job Type: Full-time

Pay: $12.00 - $14.00 per hour

Benefits:

• Paid time off

Work Location: In person