GENERAL PURPOSE

Responsible for evaluation, processing, dissemination and maintenance of all resident admission information and documents necessary to ensure accurate and timely billing and collections. Maintain ongoing communication with the facility therapy leadership and clinicians to ensure continual flow of financial information with assigned centers. Responsible for gathering all information needed to complete the pre-authorization. Complete functions of this role in within assigned time frames. This to ensure that patient’s start of treatment and satisfaction is not impacted.

ESSENTIAL JOB DUTIES

• Review all admission and readmission documents obtained and forward by facility therapy leadership for completeness, compliance and accuracy of information.

• If inaccuracy are noted, responsible for follow up to ascertain correct information.

• Contact facility therapy leadership and patient’s agent to obtain missing information

• Complies and maintains admission/financial files, organized documents in an orderly and consistent format

• Establishes patient master file for all new admission in billing system

• Review payer status changed notices; communicates changes to Billing Specialists

• Update all financial changes in the resident billing in electronic documentation system

• Handles the verification of insurance benefits for residents

• Handles and tracks all authorization

• Notifies patient’s agent of deductible and coinsurance due

• If needed, contacts primary care physician regarding preauthorization

• Call insurance companies regularly to follow up

• Provide guidance to other employees. May be responsible for training as deemed appropriate by supervisor

• All other duties as assigned

KNOWLEDGE, SKILLS, ABILITIES & BEHAVIORS

• Fundamental knowledge of healthcare admission process and a sound understanding of the impact of financial screening on billing and collections

• Comprehensive understanding of health insurance plans and entitlement programs, including eligibility and coverage criteria, application/enrollment procedures, pre-authorization, and coordination of benefits rules

• Knowledge of computers and their applications (Microsoft Office products essential)

• Ability to work independently and manage numerous tasks quickly, accurately and efficiently

• Critical thinking and analytical skills

• Strong interpersonal skills; ability to use collaborative approaches to build support for objectives; build positive relationships within and outside of the company; involving others and disseminating information; seeks solutions where all parties can contribute and benefit

• Strong English language writing and oral communication skills

QUALIFICATIONS

• High School degree or equivalent

• Some College or business school preferred

• 3-4 years experience in HealthCare admissions

• Must be capable of maintaining regular attendance

EEO Statement: Aegis Therapies and its Family of Companies is committed to a diverse workforce and is an Equal Opportunity Employer. For detailed information on your rights, Click Here (https://www.mycare.com/PublicFile/65f11946-5238-4db3-8dc8-9668ee3e78d6) OR https://aegistherapies.com/equal-opportunity-employer-provider-of-healthcare-services/ .