Insurance Authorization Clerk (Lpn)

NHC Homecare Murfreesboro , TN 37130

Posted 5 months ago

Definition:

The authorization Coordinator is a clerk or licensed practical nurse who appropriately facilitates patient authorizations during the course of care with NHC HomeCare.

Line of Authority:

Office Manager, Administrator/Director of Services, dotted line management with Director of Nurses

Job Overview:

Responsible for verifying and obtaining authorizations from insurance companies under the plan coverage for all appropriate patients. Communicates with patients with updated insurance information where applicable and coordinates the information with clinicians.

Qualifications:

  • High School Diploma. OR LPN, if Nurse position.

  • One year business/healthcare education or equivalent experience required.

  • One year experience working in a group practice or healthcare system preferred.

  • Experience in computer data entry, accounting, related field, or general office work desirable.

  • Understanding of home care operations related to patient intake and ongoing care.

  • Ability to prioritize tasks and duties.

  • Must be able to work independently and on a team, with attention to detail and accuracy.

  • Must be able to provide Excellent Customer Service

Performance Requirements:

  • Able to sit, stand or walk up to 8 hours per day.

  • Able to bend, stoop, squat and twist numerous times a day to perform duties of filing, typing, iinventory, etc.

  • Able to see and hear adequately to effectively respond to auditory and visual requests related to office activities.

  • Able to speak in clear, concise voice in order to communicate effectively in the office and on the telephone.

  • Able to carry out fine motor skills with manual dexterity required for typing, filing, etc.

  • Mental acuity to learn and apply job-related training

  • Must have reliable personal transportation.

Specific Responsibilities:

According to HomeCare policies/procedure, under the direction of the Office Manager with ongoing communication with the Director of Nursing ;

  • Receives, researches and corrects patient authorization information

  • Enters all authorizations into the NHC computer system, in a timely manner

  • Communicates and works with clinical staff on authorizations on all patients

  • Works with and assists the billing department in researching and resolving all claims

  • Researches and corrects invalid patient demographic and insurance information

  • Keeps management informed on changes in authorization process

  • Establishes and maintains a professional relationship with all staff in order to resolve problems and increase knowledge of authorization management

  • Makes photocopies for the corporate packet

  • Educates /communicates with clinical staff and patients/families regarding changes to authorization requirements.

  • As necessary, works improvement plan with leadership to raise work quality standards.

  • Attends appropriate workshops to enhance performance.

  • Performs miscellaneous typing, data entry, filing, copying duties.

  • Other duties as assigned by the Office Manager.

ANY NHC OFFICE OR CENTER


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Insurance Authorization Clerk (Lpn)

NHC Homecare