Insurance Precertification Technician, Inpatient Facility

2 weeks ago

Schenectady, United States Conifer Park Inc. Full time
Job DescriptionJob DescriptionDescription:

Conifer Park is looking for a qualified Insurance Precertification Technician for our facility in Glenville, NY. As an insurance specialist with Conifer Park, you will be responsible for verifying commercial and Medicaid insurance coverage for Intakes and reverifies benefits on patients, once admitted. This also requires working with Managed Care organizations to verify the number of days approved upfront on pending admissions and to determine what information is required upon admissions to relay to appropriate staff.


Available Shift: Monday-Friday 8:00AM-4:30PM


Additional Job Duties:

Enters benefit eligibility into the Electronic Health Record (EHR) including co-pay, deductible-pre-existing conditions, precert, NOA, detox and/or rehab coverage. Verifies eligibility on pharmacy coverage and documents in EHR. Requires working with many caseworkers and utilization review staff throughout the counties to determine Medicaid eligibility on pending intakes. Obtains and reviews temporary Medicaid cards and/or documentation from caseworkers. Contacts DSS caseworkers to assist in having restrictions removed. Requires working with MCOs to assist in resolving restricted providers on Medicaid and/or Managed Medicaid clients. Reviews admissions reports from previous day and confirms the required authorization review criteria, and documents in the EHR. Flags charts via email to alert Crisis staff that clinical assessments are required upon admission. Assess, interview and assist Clients with applications and documentation through the State of New York Marketplace Tracking, resolving and reporting Medicaid recertification, Medicaid conversion to Managed Medicaid, Medicaid restrictions, and Medicaid Pending updates. Resource to Regional staff to determine eligibility/troubleshoot eliminate roadblocks/provide resources to better assist their clients in the community. Tracking, resolving and reporting court orders on intake clients through admission process. Runs E-Paces on incoming admissions. Runs Connex on incoming admissions. Occasionally travels between Conifer Park inpatient site and Arms Acres inpatient site. Performs special projects as assigned by supervisor. Participates in Performance Improvement Initiatives.

Requirements:

High school Diploma or GED with a minimum of 3 years’ experience OR 2 years/Associate’s Degree with a minimum of 1 year experience.


We offer competitive wages, benefits, and a pension plan in a supportive working environment.

Background checks, pre-employment & drug screenings required.

We are an equal opportunity employer according to all current standards.


INDHP

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