{bc}
Apply
paycor

Guest Eligibility Specialist I

Recovery Innovations
Remote, USA
Part Time, Temporary
Mid · 4+ years experience
Remote
USD 21-22 hourly / hour
Discovered 4 weeks ago
Microsoft Excel

Full Job Posting

  • Verify insurance coverage and eligibility.
  • Knowledge of CPT, HCPCS, and ICD-10 codes.
  • Review procedure orders and documentation to determine necessity of prior authorization.
  • Provide feedback to departments, sites, and payers on project status.
  • Strong written and communication skills with providers, team members and clients.
  • Detailed documentation of authorization numbers and process for each prior authorization.
  • Maintain accurate patient medical records.
  • Make status calls to insurance companies and utilize payer portals to follow on submitted authorization for reimbursement.
  • Identify, analyze, report on trends and analysis of all payer issues and report it to the Revenue Cycle Manager.
  • Research authorization denial reasons per payers or by contacting the funders to maximize claim reimbursement.
  • Follow company processes related to submission of corrected authorizations and appeals.
  • Maintain tracking sheet of pending/resolved issues and historical payer issues.
  • Validates demographic/insurance information entered in system by staff is accurate and completed on a timely basis.
  • Reconciles eligibility/insurance coverage discrepancies.
  • Verify and identify guest insurance information through state portals.
  • Responsible for completing guest financial eligibility.
  • Understands and adheres to Recovery Innovations compliance standards as they appear in the Code of Conduct and Conflict of Interest Policies.
  • Keeps abreast of all federal and state regulations and laws and all Recovery Innovations policies as they presently exist and as they change or are modified.
  • Performs other related duties assigned.
  • Organized and detail oriented.
  • Excellent time management skills
  • High school diploma or equivalent.
  • 4+ years of registration and authorization experience required.
  • Working knowledge of CMS guidelines, contracted insurance guidelines and coding policies.
  • Detailed oriented, reliable, and able to multi-task in a fast-paced, high-volume work environment.
  • Intermediate to Advanced proficiency in Microsoft Excel.
  • Must have a valid driver license and be 18 years of age.
  • Ability to maintain a high level of confidentiality (HIPAA guidelines and regulations) and professionalism.
  • We are a Second-Chance Employer Must be able to pass a seven-year background check. Must be able to pass substance abuse testing and/or tuberculous testing (if applicable). Must be able to pass education verification check. Must be able to pass three-year motor vehicle report and meet minimum eligibility requirements criteria of insurance carrier (if driving is required for this position).
  • Must be able to pass a seven-year background check.
  • Must be able to pass substance abuse testing and/or tuberculous testing (if applicable).
  • Must be able to pass education verification check.
  • Must be able to pass three-year motor vehicle report and meet minimum eligibility requirements criteria of insurance carrier (if driving is required for this position).
  • If driving is required for this position, must meet all requirements outlined in Recovery Innovations driving policy.
  • If not qualified to drive per driving policy, a Non-Driver Attestation form must be signed.

Apply for this job in 1 click

Skip the repetitive application forms

Install the Base Career Chrome Extension and autofill job applications across major job boards with your profile.

Sarah M.James T.Maya R.

Trusted by over 500,000 job seekers on Base Career

Start Free Today

More from this employer

More jobs at Recovery Innovations

SOAR Benefits Specialist

Durham, USA

Discovered 3 weeks agoFull-time

Licensed Practical Nurse

Fayetteville, USA

Discovered 3 weeks agoFull-time

Registered Nurse

Durham, USA

Discovered 3 weeks agoFull-time

Revenue Cycle Specialist I

, USA

Discovered 3 weeks agoPart Time, Temporary

Constable

, USA

Discovered 3 weeks agoFull-time

Clinician II

Columbus, USA

Discovered 3 weeks agoPart-time

Peer Support Specialist I

, USA

Discovered 3 weeks agoFull-time

Guest Eligibility Specialist II

, USA

Discovered 4 weeks agoFull Time, Temporary