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**Job Type:** Regular

**Time Type:** Full time

**Work Shift:** Day (United States of America)

**FLSA Status:** Non-Exempt

When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives.

Position Summary:

The Insurance Verification Coordinator-Managed Care maintains and coordinates all aspects of insurance verification and demographic payer information. Assists with new authorizations and ongoing re-authorizations as coordinated with the Managed Care Coordinator.

Job Description:

Essential Duties & Responsibilities including but not limited to:

• Verifies eligibility for all new patients using various payer sites, Ability, and Medicare FISS. · Maintains correct demographic information as it pertains to insurance verifications. · Will be liaison to Intake Department to report any insurance irregularities. · Assists with new managed care authorizations and ongoing authorizations for determined payers. · Obtain clinical data from field staff and medical record system and ensure it is promptly communicated to Managed Care personnel. · Ensures clinical staffs are kept informed of the number of authorized visits per patient and due dates of authorization requests.

Organizational Requirements:

• Maintain strict adherence to the Continuing Care Confidentiality policy. · Incorporate Continuing Care Standards of Behavior and Guiding Principles into daily activities. · Comply with all Continuing Care Policies. · Comply with behavioral expectations of the Continuing Care Division. · Maintain courteous and effective interactions with colleagues and patients. · Demonstrate an understanding of the job description, performance expectations, and competency assessment. · Demonstrate a commitment toward meeting and exceeding the needs of our customers and consistently adheres to Customer Service standards. · Participate in departmental and/or interdepartmental quality improvement activities. · Participate in and successfully completes Mandatory Education. · Perform all other duties as needed or directed to meet the needs of the department.

Minimum Qualifications:

Education: · High School Graduate.

Licensure, Certification & Registration: N/A

Experience: · Prior experience in managed care. · Home Health experience required. · Insurance knowledge a plus.

Skills, Knowledge & Abilities: · Ability to pay close attention to detail and work independently. · Ability to multi-task and prioritize. · Good communications and interpersonal skills. · Must be a team player. · Proficiency with common office software programs.

Key Relationships:

Title Nature of Relationship To Position

1 Managed Care Coordinator Works collaboratively to ensure authorization has been obtained insurance has been verified and all visits will be covered as well as cross train in Managed Care Coordination as a backup.

2 Intake Reports all insurance irregularities and patient co-insurance responsibilities.

3 Intake Coordinator

Scope/Impact Statement:

Work Schedule: Indicate either Yes or No as appropriate. Hours of work may be subject to change based upon the needs of the business/department.

On Call: N/A Shift Rotation: N/A Weekends: N/A

Physical Requirements & Environment:

For each category, select ONE option from choices below by placing an X in the space to the left of the entry.

Mental and Visual Attention

X The position requires a high degree of mental and visual concentration.

Physical Exertion

Weight

X Nature of work requires lifting or moving light weight (up to 20 pounds).

Dexterity

X Flow of work and nature of duties require average manual coordination.

Range of Motion

X Responsibilities require average range of motion.

Physical Conditions

X Performance of duties requires remaining in position for prolonged periods of time.

Repetitive Motion

X Responsibilities require frequent repetitive motion.

Working Conditions

X Working conditions include minimal exposure to elements such as odor, noise, dust, chemicals, temperature extremes or airborne pathogens.

Exposure to Hazardous Materials

X Performance of duties generally does not involve exposure to hazardous materials.

Sensory Requirements (select ALL that are applicable)

aa) Performance of duties requires the ability to discern and identify colors

bb) Performance of duties requires the ability to discern sharp from dull and hot from cold

cc) Performance of duties requires the ability to hear soft and loud noises

Patient Care/Patient Contact Designation (check only one of the items listed below)

X Position facilitates the process that may impact patient access to services.

__ No patient care/contact, and does not facilitate the patient care process or directly impact health outcomes.

This Job Description is intended to describe the general nature and level of work being performed by people assigned to this classification. It is not intended to be construed as an exhaustive list of all responsibilities, requirements, duties and skills required of personnel so classified. Additional duties and responsibilities that are specific to the Department or Unit are identified and maintained by the Manager as an Addendum to the Job Description.

As a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities. Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) and COVID-19 as a condition of employment. Learn more (https://www.bilh.org/newsroom/bilh-to-require-covid-19-influenza-vaccines-for-all-clinicians-staff-by-oct-31) about this requirement.

More than 35,000 people working together. Nurses, doctors, technicians, therapists, researchers, teachers and more, making a difference in patients' lives. Your skill and compassion can make us even stronger.

Equal Opportunity** **Employer/Veterans/Disabled