Nystrom & Associates Ltd
Insurance Specialist (Finance)
Verification of Insurance Eligibility/Benefits for OP, ARMHS & CTSS servicesInitiate necessary Authorizations/Referrals as needed
Completing the auth process as applicable
Appointments are flagged accordingly
Field/Resolve provider/clinic inquiries via Email or Task
Inquiries are followed up within 24 hours of creation
Attend and participate in biweekly staff meetings and any other meetings and/or training sessions as indicated.All other duties as assigned by Management.
Expectations
Extreme attention to detail while multitaskingExtreme ability to organize and track large amounts of dataVerification Benchmarks are met on a time frame as established by Management.FlexibilityNew Patient, Referral, Termed , CD Eval, CD Orientation, CDDA, CBDA & CBADA appointments are verified within 2 business days of being scheduled
Are marked with GREEN checkmark to confirm active coverage based on Insurance coverage, Provider exceptions, and Authorization requirementsPolicies are set up correctly based on NAL approved Insurance Verification Process
Follow-up appointments are verified by the IVerify system
Any appointments found inactive are followed up on within 1 business day of the inactive verification and communicated to clinical staff.Manual reverifications of insurance not verified by the automated system are done as needed.
Initial Authorization orders are entered into Allscripts EEHR according to authorization policyInitial Authorizations are set up in Allscripts PM according to authorization policyPatient Accounts are noted appropriately in EEHR and PMRecognize/report trends and patterns with providers & clinicsRecognize/report trends and patterns with insurance companiesBack up Authorization Specialist with Authorization requests & approvalsOpen communication with Supervisor & LeadArrive and leave on time according to assigned scheduleAdhere to attendance policies
Qualifications:
Experience working with Excel preferredAbility to work on dual monitorsAbility to work in multiple software programsMinimum of two years working in health care facilities preferred, particularly with insurance verification and knowledge of prior authorization process.Familiarity with insurance company guidelines and HIPAA regulations.
Hours:
Monday through Friday 7:00-3:30 or 7:30-4:00
Benefits:
Nystrom & Associates, Ltd. prides itself on the benefits and compensation offered to staff, including:
Medical & Dental insuranceOpportunities for professional growth and career advancementHealth Savings Account (HSA)Flexible Spending Account (FSA) for applicable medical and dependent care expensesPaid Time Off (PTO)Paid Holidays401(K) Retirement Plan with a generous employer matching programSupplemental insurances,such asshort term disability, cancer insurance, and accident insurance