INSURANCE AUTHORIZATION SPECIALIST

at  CHC Solutions Inc

CHC Solutions, Inc. is currently seeking an experienced Insurance Authorization Specialist to join our team in our Pittsburgh (Robinson Township) office.

WHO WE ARE:

CHC Solutions, Inc. is a family of companies providing comprehensive medical equipment and supplies and patient-focused service. Our goal is to improve the patient experience and support individuals across the continuum of care.
Family brands include Continuum, Burmans Medical Supplies, bioCARE and HealthSource. CHC Solutions provides options for wound care, urology and enteral/nutritional supplies as well as incontinence, orthopedics and ostomy products.

In the Insurance Authorization Specialist role, you will do the following:

• Verifies insurance eligibility utilizing the methods established by CHC leadership
• Accurately enters the insurance carrier, patient identification, and eligibility information in the patients account.
• Obtains necessary clinical documentation required to justify the medical need for the product being provided - including physician medical records
• Prepares and submits pre-certification/authorization requests as needed based on insurance requirements.
• Research, follow up and resolve open & pending authorizations based on the steps outlined in the authorization follow up process.
• Contacts patients to review their financial obligations.
• Communicates with patients and referrals throughout the order process to ensure that they understand order delays
• Notes ALL correspondence with the patient/family, doctors office or insurance company in the patients account utilizing the appropriate standard note format.
• Uploads medical documents into patient accounts
• Complies with all applicable CHC Solutions policies, procedures and protocols.
• Complies with all current government regulations and professional standards respecting patient care.
• Maintains a positive, empathetic and professional attitude toward all CHC customers at all times including insurance representatives, patients and healthcare professionals.
• Participates in educational training on an ongoing basis to maintain knowledge and competency in the insurances processed by the company.

EXPERIENCE:

Insurance knowledge and customer service experience in the healthcare industry preferred

SKILLS AND ABILITIES:

• Experience in a health care environment
• Excellent typing skills and computer literacy skills (including MS Word, MS Excel, MS Outlook)
• Excellent verbal and written communication
• Proven time management, organizational skills, multi-tasking, prioritization and follow-up skills in a rapidly changing environment
• Ability to work in a fast-paced environment
• Ability to work independently, while being a productive member of the team

• Verifies insurance eligibility utilizing the methods established by CHC leadership
• Accurately enters the insurance carrier, patient identification, and eligibility information in the patients account.
• Obtains necessary clinical documentation required to justify the medical need for the product being provided - including physician medical records
• Prepares and submits pre-certification/authorization requests as needed based on insurance requirements.
• Research, follow up and resolve open & pending authorizations based on the steps outlined in the authorization follow up process.
• Contacts patients to review their financial obligations.
• Communicates with patients and referrals throughout the order process to ensure that they understand order delays
• Notes ALL correspondence with the patient/family, doctors office or insurance company in the patients account utilizing the appropriate standard note format.
• Uploads medical documents into patient accounts
• Complies with all applicable CHC Solutions policies, procedures and protocols.
• Complies with all current government regulations and professional standards respecting patient care.
• Maintains a positive, empathetic and professional attitude toward all CHC customers at all times including insurance representatives, patients and healthcare professionals.
• Participates in educational training on an ongoing basis to maintain knowledge and competency in the insurances processed by the company