Centene
health
LeadIntake&InsuranceVerificationCoordinator
Neural analysis suggests this role is
optimal for Lead candidates.
“Lead Intake & Insurance Verification Coordinator at Centene. Skills: Intake & Insurance Verification, Process Management, Cross-functional Coordination, Vendor/Stakeholder Management, Operational Metrics, Resource Planning, Continuous Improvement. Obtain and verify complete insurance information, including the prior authorization process, copay assistance and coordination of benefits.. Assist with managing the work load to ensure that referrals and orders are handled in a timely manner”
What You'll Achieve.
ensure that referrals and orders are handled in a timely manner
Industry & Context.
redistribute work as appropriate; Identify and coordinate patient resources
Must be able to work 12PM-9PM EST as well as overtime and weekend hours as needed, Must be authorized to work in the U. S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT.
What They're Looking For.
Must Have
3+ years of medical billing, insurance verification experience, call center, and/or previous experience as a lead managing cross functional teams required, Experience with payors and prior authorization requirements
What You'll Do.
Obtain and verify complete insurance information
including the prior authorization process
copay assistance and coordination of benefits.
Assist with managing the work load to ensure that referrals and orders are handled in a timely manner
Monitor each queue through various reports and redistribute work as appropriate
Serve as the point of contact for key physicians’ offices and coordinate referrals with the sales team during insurance verification process
Serve as the point of contact or designated rep for contracted payors
Serve as the point of contact or designated rep for special pharma accounts working with their HUB’s and collecting and documenting pharma •specific data in the system
Obtain and verify insurance eligibility for services provided and document complete information in system
Perform prior authorizations as required by payor source
including procurement of needed documentation by collaborating with physician offices and insurance companies
Collect any clinical information such as lab values
Determine patient’s financial responsibilities as stated by insurance
Configure coordination of benefits information on every referral
Ensure assignment of benefits are obtained and on file for Medicare claims
Bill insurance companies for therapies provided
Document all pertinent communication with patient
insurance company as it may relate to collection procedures
Identify and coordinate patient resources as it pertains to reimbursement
third party assistance programs
and manufacturer assistance programs
Handle inbound calls from patients
and/or insurance companies
Performs other duties as assigned
Complies with all policies and standards
How You'll Work.
Team & Collaboration
cross-functional teams; coordinate referrals with the sales team; collaborating with physician offices and insurance companies
Communication Scope
Handle inbound calls from patients, physician offices, and/or insurance companies; Document all pertinent communication with patient, physician, insurance company
Full Job Description
You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. ***Qualified candidates must be able to work 12PM-9PM EST as well as overtime and weekend hours as needed*** _ **Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT.**_ **Position Purpose:** Obtain and verify complete insurance information, including the prior authorization process, copay assistance and coordination of benefits. * Assist with managing the work load to ensure that referrals and orders are handled in a timely manner * Monitor each queue through various reports and redistribute work as appropriate * Serve as the point of contact for key physicians’ offices and coordinate referrals with the sales team during insurance verification process * Serve as the point of contact or designated rep for contracted payors * Serve as the point of contact or designated rep for special pharma accounts working with their HUB’s and collecting and documenting pharma •specific data in the system * Obtain and verify insurance eligibility for services provided and document complete information in system * Perform prior authorizations as required by payor source, including procurement of needed documentation by collaborating with physician offices and insurance companies * Collect any clinical information such as lab values, diagnosis codes, etc. * Determine patient’s financial responsibilities as stated by insurance * Configure coordination of benefits information on every referral * Ensure assignment of benefits are obtained and on file for Medicare claims * Bill insurance
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