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AdaptHealth logo
AdaptHealth

Empowering patients to live their best lives

Intake Specialist – Insurance Verification

InsuranceInsuranceOtherRemoteJuniorTeam 10,001+Since 2019H1B No SponsorCompany SiteLinkedIn

Location

United States

Posted

120 days ago

Salary

0

Seniority

Junior

High School1 yr expEnglish

Job Description

Intake Specialist – Insurance Verification

AdaptHealth

• Accurately enters referrals within allotted timeframe as established; meeting productivity and quality standards as established • Communicates with referral sources, physician, or associated staff to ensure documentation is routed to appropriate physician for signature/completion • Works with leadership to ensure appropriate inventory/services are provided • Communicates with patients regarding their financial responsibility, collects payment and documents in patient record accordingly • For non-Medicaid patients communicate with patients • Responsible for reviewing medical records for non-sales assisted referrals to ensure compliance standards are met prior to a service being rendered • Follows company philosophies and procedures to ensure appropriate shipping method utilized for delivery of service • Answers phone calls in a timely manner and assists caller • Reviews medical records for non-sales assisted referrals to ensure compliance standards are met prior to a service being rendered • Demonstrates expert knowledge of payer guidelines and reads clinical documentation to determine qualification status and compliance for all equipment and services • Works with community referral sources to obtain compliant documentation in a timely manner to facilitate the referral process • Contacts patients when documentation received does not meet payer guidelines, provide updates, and offer additional options to facilitate the referral process • Works with sales team to obtain necessary documentation to facilitate referral process, as well as support referral source relationships • Must be able to navigate through multiple online EMR systems to obtain applicable documentation • Works with insurance verification team to ensure all needs are met for both teams to provide accurate information to the patient and ensure payments • Assume on-call responsibilities during non-business hours in accordance with company policy • Supervise and provide guidance to team members in daily operations and complex case resolution • Lead team meetings and facilitate training sessions for staff development • Monitor team performance metrics and productivity standards, providing feedback and coaching as needed • Serve as primary escalation point for difficult customer issues and complex regulatory compliance questions • Develop and implement process improvements and workflow optimization strategies • Coordinate with management on staffing needs, scheduling, and resource allocation • Conduct new employee onboarding and ongoing training programs • Maintain advanced expertise in Medicare guidelines, payer policies, and regulatory changes to guide team decisions • Prepare reports and analysis on team performance, trends, and operational metrics for management review • Maintains patient confidentiality and functions within the guidelines of HIPAA

Job Requirements

  • High school diploma or equivalent required
  • Associate’s degree in healthcare administration, Business Administration, or related field preferred
  • Related experience in health care administrative, financial, or insurance customer services, claims, billing, call center or management regardless of industry
  • Exact job experience is health care organization, pharmacy that routinely bills insurance or provides Diabetics, Medical Supplies, HME, Pharmacy or healthcare (Medicare certified) services
  • Specialist Level: (Entry Level): One (1) year of work-related experience
  • Senior Level: One (1) year of work-related experience plus Two (2) years exact job experience
  • Lead Level: One (1) year of work-related experience plus Four (4) years exact job experience

Benefits

  • N/A

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