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Eligibility & Authorization Specialist
4 months ago
The Doctor’s Choice is a licensed Home Health Services agency that provides a full range of in-home medical, rehabilitative, custodial, and companionship services to individuals and families throughout Los Angeles County. Whether you or a loved one is in need of medical care, housekeeping, physical therapy, or companionship, we are here to help. Our staff strives to raise the bar when it comes to in-home medical services, companionship, and domiciliary care for children, adults, seniors, and their families. By hiring the best team in the field and continuously educating our employees, our highly skilled team is more than capable of managing every aspect of a patient’s health and well-being from the familiarity and comfort of home.
**Responsibilities**
- This role works directly with patients, insurance companies, and clinical departments to verify insurance coverage, obtain proper authorizations.
- Determines deductibles, copayments, coinsurance, CPT and Diagnosis/Procedure Codes, Medical policies, LCD s and Medical terminology.
- Reviews physician orders for medical necessity and accuracy and provides clinical documentation to support proper authorization.
- Provide patient education of service benefits, status of pending or denied authorizations and for limited benefit coverage.
- Accurately enters insurance benefits and authorization information into patient accounts.
- Effectively working with insurance companies, with extensive amount of time on the telephone.
- Provide feedback to staff of patient benefits/authorization in a timely manner.
- Assist with submission appeals and follow up with unpaid claims.
- Create patients’ statements.
- Performs other duties as assigned.
**Qualifications**
- At least 1 year of knowledge and experience in Insurance benefits verification, Authorization requests, and referral requests for Medicare, PPO, HMO, and IPA insurances.
- Positive, caring attitude, and self-motivated to do whatever is necessary to provide.
- Outstanding patient service and do whatever is needed to ensure effective operations.
- Intermediate level skill in Microsoft Excel, Word, and Outlook.
- Can multitask, prioritize, and manage time effectively.
- Have Impeccable attention to detail.
- Enjoys working both independently and collaboratively as part of a team.
- Open to learn and improve skills.
- Education/Licensure/Certification: High School diploma or equivalent
Pay: $20.00 - $24.00 per hour
**Benefits**:
- 401(k)
- 401(k) matching
- Dental insurance
- Employee discount
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Weekly day range:
- Monday to Friday
**Experience**:
- Insurance verification: 1 year (required)
- Medical billing: 1 year (required)
Ability to Commute:
- Los Angeles, CA 90048 (required)
Work Location: In person
