Role & seniority: Insurance Verification / Revenue Cycle Associate (non-exempt); hospice reimbursement support; 2+ years preferred.

Stack/tools: Electronic Medical Records (EMR); Medicare/Medicaid benefit portals; MITS portal for Medicaid; Microsoft Word, Excel, Outlook.

Top 3 responsibilities

Verify insurance benefits for Medicare, Medicaid, Medicaid Managed Care, and commercial payers; obtain authorizations as needed.
Document benefits, authorizations, and other data in the EMR; assist with or perform reauthorization before current period ends.
Collaborate with payors, case managers, and internal teams to address eligibility, certification, and appeals; support reimbursement processes and related assignments.

Must-have skills

2+ years in medical insurance verification and healthcare billing; 2+ years in EMRs (preferred).
Proficiency with Word, Excel, Outlook; strong customer service and communication; detail-oriented; able to work in fast-paced environments.
Ability to work independently and in a team.

Nice-to-haves

Experience with MITS Medicaid portal; hospice reimbursement processes.

Location & work type: Cleveland, OH (17876 St. Clair Ave.); non-exempt role; hybrid of office and patient-care settings; may involve home environment visits; some travel and exposure to clinical settings.

Full Description

JOIN US IN MAKING THE MOST OF EVERY DAY!

Hospice of The Western Reserve operates in celebration of the individual worth of each life, we strive to relieve suffering, enhance comfort, promote quality of life, foster choice in end-of-life care and support effective grieving.

WHY US?

We believe that our success starts with our greatest asset: OUR EMPLOYEES!

We live our shared core values in everything we do

COMPASSION. EXCELLENCE. EQUALITY. INTEGRITY. SERVICE. STEWARDSHIP.

We have a passion for purpose-driven work! Do you?

JOIN OUR FAMILY!

Verifies medical insurance coverage for all pay sources. Obtains authorization for services as needed. Performs various clerical functions related to reimbursement of services. Works collaboratively and in conjunction with the Referral, Assessment, Liaison, Care Solutions Center, Centralized Medical Records, and Financial Services teams.

WHAT YOU WILL DO

Identifies new referrals in the EMR (electronic medical record).
Verifies Medicare benefits on the appropriate online site.
Verifies Medicaid and Medicaid Managed Care benefits on the appropriate online site.
Assists and/or performs the verification of commercial insurance benefits as identified, as well as obtains authorizations as needed.
Documents insurance benefits, authorizations, and other pertinent information in the EMR according to established procedures.
Works with appropriate staff and the payors’ case managers to reauthorize services prior to expiration of current authorization period.
Processes explanation of insurance benefits letters for commercial insurance patients and subcontracted services.
Notifies Medicaid of hospice spans for Medicare and Medicaid dually eligible patients via the MITS portal.
Problem solves eligibility, certification, and appeals issues.
Assists in the continued development of the verification, admission, and reimbursement processes.
Completes special assignments/projects and other duties as assigned.
Demonstrates effective Service Excellence skills according to agency guidelines.
Performs identified back-up functions as assigned by supervisor.

SUCCESS CAPABILITIES

Two (2) or more years’ experience in medical insurance verification and healthcare billing preferred.
Two (2) or more years’ experience with electronic medical records preferred.
High School diploma.
Proficient in Microsoft Word, Excel, and Outlook.
Ability to compose and type business correspondence.
Must be detail oriented and able to work in a fast-paced environment.
Must demonstrate strong customer service and communication skills.
Flexibility to work both independently and in a team environment.

DETAILS

Total Rewards Package to include Retirement, Health, Dental, Vision, voluntary benefits and Corporate Discounts
Tuition Assistance
Non-exempt role
Protocols in place for wellbeing during COVID-19

CONDITIONS OF EMPLOYMENT

Compliance to Annual Vaccination Policy or ability to provide exemption documentation
Ability to provide proof of eligibility to work in the United States.
High level of integrity, ethics and professionalism.

PHYSICAL REQUIREMENTS AND WORKING CONDITIONS

This position requires the duties be completed in both office-type settings and patient care settings. May include making visits to a variety of home environments with prolonged telephone or computer use at times. Could require the exertion of up to 20 pounds of force occasionally; work requires sitting, stooping, bending, kneeling, reaching, standing, fingering, grasping and repetitive motions; vocal communication; hearing, and visual acuity. This position has the potential to be exposed to environmental elements, internal and external, such as infectious disease, bloodborne pathogens, and chemicals and/or chemical fumes, (pet dander and/or exposure to allergens) and adverse effects of inclement weather that may occur as well as potentially difficult patient and family situations.

NOTE: The responsibilities of this position are described above, and they may be subject to change at any time due to reasonable accommodations or other reasons. Also, this description in no way states or implies that these are the only duties to be performed by the employee occupying this position.

Applicants who may need reasonable accommodations to complete the application process may contact

Careers at Hospice of the Western Reserve

17876 St. Clair Ave.

Cleveland, OH 44114

383.2222

Hospice of the Western Reserve is an Equal Opportunity Employer and encourages Women, Minorities, Individuals with Disabilities, and protected Veterans to apply.

Insurance Verification Coordinator