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Eligibility & Authorization Coordinator at The Care Team in Farmington Hills, Michigan

Posted in General Business 30+ days ago.

Type: Full-Time





Job Description:

The Care Team - The care you deserve and the support you need.

Come join our growing team! The Care Team is looking for a Full-Time Eligibility and Authorization Coordinator in Farmington Hills, MI. We specialize in providing Home Care and Hospice in the home and facilities. If you are looking for a new and exciting opportunity, we encourage you to apply today. A member of the recruiting team will be in contact with you to discuss this opportunity in more detail. At the Care Team we offer:


  • Engaging Company Culture
  • Competitive Compensation and Excellent Benefits
  • Growth from within through training, supportive leadership, and collaboration with the best of the best in your field
  • Independence, Autonomy, and Flexibility!
  • Innovation and industry-leading systems and technology
As a member of The Care Team, you will enjoy a wealth of great benefit choices including:

  • A full benefits package including Health, dental, and vision
  • 401k with company match
  • Generous Paid Time Off
  • Paid Holidays
  • Flexible spending
  • Company Paid and optional Life and Long-Term Disability, Short Term Disability
  • Accident Coverage
KEY JOB RESPONSIBILITIES:

The Eligibility and Authorization Coordinator is responsible for determining patient eligibility for insurance benefits, typically prior to treatment. Responsibilities include staying current with insurance requirements, maintaining logs of denied claims, managing room and board eligibility, and ensuring payor set-up is correct.

Additionally, the Eligibility/Authorization Coordinator will be responsible for:

Eligibility Verification


  • Run and review eligibility information and update patient demographic/payor source information based on response.
  • Obtain commercial insurance verification, research eligibility information when the payor is a commercial plan and patients are triggered for this plan.
  • Verify Medicaid eligibility.
  • Verify room and board eligibility.
Authorization

  • Contact the payor and obtain authorization for the start of care when the payor is authorization-driven (not Medicare).
  • Obtain enter visits for the start of care.
  • Determine and enter authorization for Self-Pay patients.
  • Review/approve out-of-network benefits.
Other Responsibilities

  • Complete payor source verification to finalize research on eligibility information.
  • Review entitlement verification report to ensure payor is correct.
  • Update clinical notes with eligibility information for Hospice.
  • Periodically reverify eligibility and payor source eligibility.
  • Run reports as outlined in the Eligibility/Authorizations Coordinator SOP.
  • Perform any other responsibilities as outlined in the Eligibility/Authorizations Coordinator SOP.

Qualifications


  • High school diploma or equivalent.
  • Minimum 1 year experience in billing, authorizations, and eligibility required.
  • Home Care and Hospice experience preferred.
Regulatory Requirements

  • Must pass a criminal background check & MVR check.
  • Completed health statement acknowledging ability to perform the duties of the position.
  • Valid state driver's license.





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