Medical Insurance Coordinator, Full-time, Remote - Center for Wound Healing & Hyperbaric Me : Job Details

Medical Insurance Coordinator The Center for Wound Healing & Hyperbaric Medicine (CFWH) provides management and consulting services to healthcare providers in the area of wound care and hyperbaric medicine. By focusing on the needs of the patients as well as the partners we serve, The Center for Wound Healing & Hyperbaric Medicine is able to bring advanced wound healing strategies to many communities around the country.Job Overview at Center for Wound Healing & Hyperbaric Medicine LLC:Responsible for timely and accurate processing of insurance verifications, referrals, authorizations, appeals, and grievances.Essential Responsibilities:

• Perform insurance verification and referral processing in accordance to facility timelines.
• Monitor and audit all authorizations and appeals.
• Contact physician to resolve issues regarding prior authorizations or grievances.
• Perform electronic eligibility confirmation when applicable and document results.
• Contact patient via phone to confirm or obtain missing demographic information.
• Communicate with hospital, patient or physician to ensure prompt resolution of coverage issues.
• Complete and accurately documents communications with payors, patients and treatment team.
• Data entry of benefit information into practice management software.
• Complete work within required time frames.
• Assist Director of Nursing with clinical review of new patient referrals to determine medical acceptance, as required.
• Communicate with unit managers and physicians regarding patients who fail to meet medical criteria for acceptance.
• Use clinical knowledge to obtain medical overrides, gaining authorization for services, and coordinating predetermination processes.
• Use excellent oral communication and listening skills to communicate with patient, referral source, physician and clinical staff regarding obstacles to access clearance.
• Collaborate with all areas of patient care.
• Perform other duties as assigned, including performing various clerical or administrative functions for Director of Revenue Cycle Management and CEO.
• Other duties as assigned.

Required Qualifications for This Role Include:

• Minimum High School diploma required.
• 3+ years Medical Insurance experience with knowledge of payer requirements, preferably both institutional and professional.
• Excellent organizational, analytical, and customer service skills.
• Excellent attention to detail and follow up skills.
• Strong verbal and written communication skills
• Able to work effectively with other employees, patients, physicians and external parties.
• Must be detail oriented and highly organized.
• Ability to exercise judgment with minimal supervision, take initiative and problem solve.
• Must be able to work in a fast-paced environment.
• Knowledge of ICD 9 and ICD 10 coding and Medical terminology.
• Comprehensive and broad understanding of current trends in health care.
• Proficient in Microsoft Office: Word, Excel, PowerPoint, Outlook.
• Positive background check, negative drug screen, and hospital credentials (as needed) required.

Travel:

• This position may require light ground and/or air travel.

Physical Demands:

• The physical demands described are representative of those that must be met by a Medical Insurance Coordinator to successfully perform the essential competencies, duties, and requirements of this position. These include standing, walking, driving, lifting up to 50 pounds and sitting for extended periods of time. In addition, pushing, pulling, stooping, squatting and shifting heavy objects, as well as air travel, may be required. Employees should ask for assistance if needed.

Core Values We Admire:

• Respect and dignity
• Commitment to quality of care
• Compassion
• Improving lives
• Working together for people
• Everyone counts

What We Offer:

• Insurance benefits: medical, dental, vision
• Supplemental health insurance options (accident, cancer, hospital, plus more)
• Life Insurance & Disability
• Paid Time Off (PTO) & Company Holidays
• Internal promotion opportunities
• 401(k) Plan

All employees are required to comply with HIPAA policies and procedures.