Carreras

Algunos puestos pueden estar ubicados fuera de nuestra oficina en Colorado (puestos exclusivamente remotos). Los puestos ubicados fuera de nuestra oficina principal pueden encontrarse en cualquiera de los siguientes estados: AZ, CO, CT, FL, GA, ID, IL, KS, MA, MD, MI, MN, NC, NJ, OH, OR, PA, SC, TN, TX, UT, VA, WA y WI. Por favor, postúlate únicamente si puedes residir y trabajar principalmente en uno de los estados enumerados anteriormente. Las ubicaciones de los estados y los detalles específicos están sujetos a cambios a medida que cambien nuestros requisitos de contratación.

Acerca de la Oportunidad:

This role is responsible for the accurate and timely verification of insurance and benefits information for patients at Vail Health. The position plays a key role in supporting the organization’s financial health by ensuring financial clearance prior to service and maintaining accurate patient demographic and insurance information for proper claims processing.

Horario:
This position operates on a standard schedule of 8:00 AM – 4:30 PM MST and requires adherence to this time zone regardless of location.

Lo que harás:

• Utilize online systems, phone communication, and other resources to determine eligibility and benefits prior to scheduled appointments in accordance with Vail Health timelines
• Accurately identify and assign payer plan codes in the organization’s electronic health record system
• Verify medical necessity in accordance with Centers for Medicare & Medicaid Services (CMS) standards and communicate coverage and eligibility details to patients
• Communicate with patients, physicians, clinicians, front-end staff, and translators to gather any additional required information
• Identify and obtain missing patient demographic, insurance, or pre-authorization details
• Coordinate benefits by determining primary and secondary liability when applicable
• Obtain pre-certifications and pre-authorizations from third-party payers per payer requirements
• Escalate complex cases and notify patients or physician offices of any issues impacting verification or eligibility
• Communicate patient financial responsibility directly or partner with appropriate staff to review payment and financial assistance options
• Demonstrate and uphold the principles of a Just Culture
• Perform other duties as assigned; must remain HIPAA compliant

This description is not intended to be an exhaustive list of all responsibilities, skills, or working conditions, but rather an overview of the general scope of the role.

Lo que necesitará:

Experiencia

• One year of customer service experience preferred
• Insurance verification or healthcare experience preferred
• At least one year of professional experience using Epic, specifically working with and verifying Physical Therapy and/or Occupational Therapy workflows, is strongly preferred.

Licencia(s) y Certificación(es):

• N/A

Educación:

• Degree in healthcare administration or a related field preferred