Eligibility Specialist (REMOTE)
Job description
Aveanna Healthcare is the largest provider of home care to thousands of patients and families, and we are looking for caring, compassionate people who are driven to fulfill our mission to revolutionize the way pediatric healthcare is delivered, one patient at a time.
At Aveanna, every employee plays an important role in bringing our mission to life. The ongoing growth and success of Aveanna Healthcare remain dependent on our continued ability to consistently deliver compassionate, committed care for medically fragile patients. We are looking for talented and committed individuals in search of a rewarding career with a company that values Compassion, Integrity, Accountability, Trust, Innovation, Compliance, and Fun.
Position Overview
The Insurance Verification Representative is responsible for verifying insurance coverage for active patients that are showing not eligible. Insurance Verification Representative must possess exceptional customer service and communication skills. This position requires a team mentality, admirable interpersonal skills, excellent organizational skills, written skills, knowledge of medical terminology and insurance, and computer and phone skills.
Essential Job Functions
- Verify insurance coverage electronically using company Electronic Medical Record (EMR) system. by phone or payer web portal for continued services.
- Enter demographics and other pertinent information in the company’s EMR system and ensure completion of all insurance changes.
- Explain benefit information to patients.
- Work tasks assigned to the Eligibility Team by other departments in a timely manner. These may include insurance changes, additional insurance information provided/needed coordination of benefits, eligibility/benefit check, review of in and out of network benefits, review for DME coverage, claim denied due to no coverage.
- Review copies of insurance cards received from patients.
- Responsible to task other departments when there is a change in a patient’s insurance health coverage
- Notify the correct team if a transition is needed due to being out of network and provide in-network provider name.
- Communicate effectively with other departments to present solutions to any patient concerns.
- Support the Aveanna mission and culture by demonstrating our core values, compassion, team integrity, accountability, trust, innovation compliance and fun.
- Adhere to the Aveanna Compliance Program, including following all regulatory, Aveanna and accrediting agency policy requirements.
- Maintain the skills and qualifications necessary to provide or support quality care, including attendance at company-wide educational programs.
- Responsible for submitting accurate time and attendance records and following proper procedures for reporting and making corrections to attendance records.
- Responsible for harmonious interactions with coworkers and customers, including patients, medical office staff, vendors, and the general public.
- Upon employment, all employees are required to fully comply with Company’s policies and procedures.
Requirements
- Minimum Education: High school diploma or GED
- Minimum Experience: Minimum of 2 years related experience
Preferences
- Preferred Education: Education or experience equivalent to a bachelor’s degree in related field highly preferred
- Preferred Experience: Home Health/DME related experience preferred; knowledge of insurances a plus
- Proficient in Microsoft suite of products including Outlook, Word and Excel.
- Self-starter, able to display the highest level of integrity and respect for confidentiality.
- Ability to exercise effective judgment and sensitivity to changing needs and situations.
- Must have strong organization skills and be very detail-oriented.
- Must possess a strong sense of urgency and attention to detail.
- Excellent written and verbal communication skills.
- Proven ability to work independently at times and within a team.
- Ability to adapt to change.
- Demonstrated ability to prioritize multiple tasks to meet deadlines.
- Demonstrated ability to interact in a collaborative manner with other departments and teams.
Other Duties
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.
Vaccination Requirements
As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all relevant jurisdictions, including required vaccinations and testing, subject to exemptions for medical or religious reasons as appropriate.
Equal Employment Opportunity and Affirmative Action: Aveanna provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, Aveanna complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.
As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all relevant jurisdictions, including required vaccinations and testing, subject to exemptions for medical or religious reasons as appropriate.
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