Insurance Specialist

This is a fully remote position, open to applicants in California, +3 more states.

📋 Description

• Exemplify Compassus values and advocate for the Compassus philosophy through the 6 Pillars of Success.

• Adhere to the Code of Ethical Conduct while fostering positive working relationships.

• Secure and monitor insurance verification and authorization/re-authorization for home health care services.

• Conduct insurance verification for both new and existing patients and follow up on authorization requests.

• Liaise with insurance carriers to discuss benefit coverage, policy limitations, authorization/notification, and pre-certifications.

• Request authorization from insurance company case managers for specific services and care parameters.

• Utilize knowledge of Medicare, Medicaid, third-party payer requirements, and online eligibility systems.

• Review insurance verification and ensure completion of authorization processes within set time frames.

• Maintain a strong understanding of the revenue cycle, including insurance requirements, billing, and correspondence.

• Independently address insurance and revenue-cycle challenges.

• Contribute to team efforts in authorization and verification processes.

• Communicate effectively with team members and healthcare professionals while upholding confidentiality.

• Execute other duties as assigned.

⛳️ Requirements

• High school diploma or GED is mandatory.

• Proficient in adding, subtracting, multiplying, and dividing whole numbers, common fractions, and decimals.

• Capability to compute rates, ratios, and percentages.

• Ability to read, analyze, and interpret business periodicals, professional journals, technical procedures, and governmental regulations.

• Competence in writing reports, business correspondence, and procedure manuals.

• Skill in presenting information and responding to inquiries from leaders, team members, investors, and external parties.

• Excellent written and verbal communication skills.

• Proficient in understanding, reading, writing, and speaking English.

• Familiarity with insurance policies relevant to home care authorizations.

• Ability to establish and maintain effective working relationships with branch staff, billing and collections departments, and insurance representatives.

• Self-motivated individual capable of working independently.

• Strong multitasking abilities.

• Knowledge of medical terminology.

• Strong negotiation and conflict management skills.

• Computer literacy with the ability to learn new software applications.

• Proficient in using basic office equipment.

• Ability to stand, walk, and perform manual dexterity tasks regularly.

• Capability to lift and move objects weighing up to 25 pounds.

• Required visual acuity including close and distance vision, color and peripheral vision, depth perception, and focus adjustment.

• One or more years of experience in insurance authorization is preferred.

• Prior experience in the home health care insurance industry is desirable.

• Experience in utilization management and pre-certification is advantageous.

• Customer service experience is preferred.

🏝️ Benefits

• Flexible time off.

• Tuition reimbursement.

• Wellness programs.

• Leadership pathways.

• Mentorship opportunities.

• Customized professional development.

• Recognition programs.

• A supportive team utilizing the latest tools and technologies.

• A culture that emphasizes belonging, diversity, and inclusion.