Insurance and Reimbursement Specialist - WellSpan Rehabilitation - part-time

York, PA | Clerical and Administrative | Tracking Code: 56719

Position Summary:


Flexible scheduling; 20 hours/ week; Days
Monday through Friday

 

 

General Summary:
Under general supervision of Supervisor-Reimbursement and Denials, maintains accurate records of verifications, authorizations and visit limitations to maximize reimbursement for the department. Educates and updates rehab staff on proper verification and authorization procedures in accordance with current payor regulations. Obtains timely documentation and other information to maintain patient eligibility for rehabilitation services. Performs a variety of other functions including, but not limited to, account follow-up, answering inquiries, resolving problems, and interacting with insurance companies and/or patients to achieve payment of accounts to minimize denials for services rendered. Manages insurance denials to attain reimbursement.

Duties and Responsibilities:
1. Performs various functions to initiate and expedite the insurance authorization process including, but not limited to, verifying patient insurance information, correcting and updating data, maintaining ongoing authorizations for services.
2. Tracks patient authorizations and visit limitations to avoid unnecessary delays in service or denial of services rendered.
3. Communicates through written, verbal and/or online inquiries with the front office, therapists and insurance companies to accurately obtain the information needed for verifications, authorizations and reimbursement.
4. Researches accounts to determine the reason for denial and work the denial to resolution by investigating denial from work queue, communicating with insurance companies and providing required documentation to support getting the denial overturned.
5. Interprets and explains the individual insurance benefit services and policies to the patient and/or family as needed.
6. Periodically reviews and analyzes insurance updates regarding verification and authorization procedures and guidelines for the department that may have changed.
7. Participates in department meetings as expected.



 

Required Skills

High School or G.E.D.

Medical Terminology

Exceptional communication/ interpersonal skills

Detail oriented

 

Required Experience

1-2 years 

Healthcare administrative background

Insurance background preferred

Solid and stable work history


Quality of Life

WellSpan Health is an integrated health system that serves the communities of central Pennsylvania and northern Maryland. The organization is comprised of a multispecialty medical group of more than 1,500 physicians and advanced practice clinicians, a regional behavioral health organization, a home care organization, eight respected hospitals, more than 19,000 employees, and 170 patient care locations. WellSpan is a charitable, mission-driven organization, committed to exceptional care for all, lifelong wellness and healthy communities. We are committed to transforming the health of the communities we serve and to educating the next generation of clinicians, staff and leaders.

Quality of Life
Quality of Life

Founded in 1741, the city of York is considered by many as the first capital of the United States. The Articles of Confederation were signed by the Second Continental Congress here in 1777. Its beautifully restored historic district is an architectural treasure. While York retains its farming and manufacturing heritage, at its heart York is a thriving cultural community that has attracted creative talent and innovative entrepreneurial investors from across the nation.

Life in York County offers affordable housing, options for higher education, a thriving arts and cultural community, historical attractions, parks and recreational resources, semi-professional baseball team, fine dining and more — within an easy drive of major East Coast cities.

York County residents can find local employment in healthcare, manufacturing, technology, agricultural and service sectors. (Patient population: 445,000)

Equal Opportunity Employment

WellSpan Health is an equal opportunity employer. Employment selection and related decisions are made without regard to sex, race, age, disability, religion, national origin, color or any other protected class. WellSpan Health does, however, have a tobacco-free/nicotine-free hiring policy.

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