Eligibility & Authorization Coordinator

We don’t train our people to be nice… We simply hire nice people
We are looking for the brightest and the best to join our team!
Are you under challenged in your current position? Are you looking for a career in a high paced complex clinical environment?
Three major benefits offered by Cure 4 The Kids Foundation

• 40-hour work week, no nights or weekends
• One of the most competitive compensation and comprehensive benefit packages in the field of healthcare
• A state-of-the-art clinical and administrative environment located at 215 and Town Center, Summerlin on the Roseman University Campus

Cure 4 The Kids Foundation was voted #10 on the list of the 50 Best Non-Profits to Work For in The U.S.
What it takes to be part of our team
Are you an exceptional Eligibility and Authorization Coordinator who absolutely thrives on being part of an accountable team? Can you dedicate yourself to being part of a team serving the needs of children and their families? Do you bring the highest standards of integrity and professionalism to your team? Do you thrive in an environment where you are valued and appreciated for who you are, how hard you work and for that something special you bring to the teams you choose to work with? Are you looking for an organization that offers competitive compensation and one of the broadest and most comprehensive benefit packages available in the field of healthcare?
This is a role that requires a multi-disciplinary team approach to solving problems and patient challenges. "That's not my job" or "someone else can do it" is not in our team vocabulary because we are here to be of support to each other. The primary goal is to bring the best patient care and experience for our area's children.
POSITION DESCRIPTION
Responsible for verifying benefits and eligibility for all patients, as well as obtaining necessary authorization and referrals for office visits, labs, physical therapy, speech therapy, and neuropsychology services. Responsible for coordinating benefits by calling and obtaining information from patients, payers, and other medical offices.
ESSENTIAL DUTIES AND RESPONSIBILITIES

• Verify all scheduled and walk-in patient’s eligibility and benefits before the patient is seen.
• Verify eligibility and benefits for all new patients, as requested by New Patient Coordinators.
• Verify eligibility and benefits for all hospital billing.
• Obtain authorizations and referrals for office visits and labs for all existing patients, as required by the insurance coverage for payment.
• Obtain prior authorization for physical therapy and neuropsychology services. Monitor approved units and renew authorizations as needed.
• Update the practice software to reflect the patient’s current and expired insurance policies. Notate relevant insurance coverage information and other key plan changes.
• Process coordination of benefits following generally accepted guidelines. Submit coverage termination and additions to HMS when necessary.
• Communicate with payers, patients, and other medical offices in a professional manner.
• Communicate all changes in individual patient’s eligibility and benefits to appropriate staff within the organization.
• Verify coverage for past visits to determine coordination of benefits and retro terminations, upon request. Notify the payers to update coordination of benefits.
• Communicate with patients to obtain current insurance coverage information. Provide self-pay estimate to uninsured new patients and existing patients scheduled for follow up visits.
• Participate in educational activities, team huddles, and meetings with other departments to improve revenue cycle efficiency.
• Maintain strictest confidentiality; adhere to all HIPAA guidelines/regulations.
• Submit reports as directed by supervisor.
• Perform other duties as directed.

Education and/or Experience: Completion of a high school diploma or equivalent. Associated Degree is preferred. Minimum of one (1) year of experience in insurance eligibility verification. Previous experience in authorization is strongly preferred. Must have at least two (2) years of experience in tertiary patient care setting involving interactions with a variety of medical services, contact with patients and families, and interaction with physicians.
KNOWLEDGE, SKILLS, and ABILITIES:

• Knowledge of medical billing/collection practices.
• Knowledge of computer programs.
• Knowledge of business office procedures.
• Knowledge of coordination of benefits guidelines.
• Knowledge of managed care and other insurance plan benefits and coverage.
• Experienced with insurance benefits and eligibility.
• Experienced with insurance authorization process.
• Excellent communication skills.
• Works very well under pressure.
• Ability to establish and maintain effective working relationships with patients/parents, fellow employees and the public.
• Must be well organized and detail oriented.
• Maintain strictest confidentiality; adheres to all HIPAA guidelines/regulations

PHYSICAL DEMANDS: Position requires sedentary work, occasionally lifting up to 10 pounds. Carrying small objects short distances. Ability to sit 6-7 hours daily at a computer terminal. Ability to use keys on a computer terminal keyboard.
HEALTH REQUIREMENT: Cure 4 The Kids Foundation complies with the Medicare and Medicaid mandatory Covid vaccination requirements. Must be fully vaccinated.
LANGUAGE SKILLS: Bilingual (English/Spanish) preferred, but not required.
CURE 4 THE KIDS FOUNDATION PARTICIPATES IN E-VERIFY.

8:30 AM - 5:00 PM

Job Type: Full-time

Salary : $33,400 - $42,300