Insurance Authorization Coordinator-Lead-HCS

Job Description

Job ID: 1189698
Employment Status: Full-Time
Your Career. Made Better.

BJC Home Care Services offers patients and their families a complete range of home care services, including skilled nursing services, adult and pediatric hospice and supportive care, rehabilitation therapy, home infusion therapy, infusion treatment rooms, home medical equipment and high-tech respiratory care. Specialty home care programs also are available, including adult and pediatric asthma, cardiac, diabetes, orthopedic and wound care programs as well as the Lifeline emergency response system. BJC Home Care Services provides care to thousands of patients in both Missouri and Illinois. Serving more than 25 counties, it has become the largest home care network in the region and one of the largest in the country.

The Home Infusion Therapy Department of BJC Home Care Services works closely with physicians, patients and caregivers to enable patients to remain or return home while receiving intravenous medications. Our services include 24 hour on-call pharmacy and nursing services, comprehensive patient education materials, patient assessment and drug administration monitoring, and coordination of professional services including home care nursing and laboratory services.


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Role Purpose

The Insurance Authorization Coordinator Lead is responsible for ensuring that the organization has the appropriate insurance pre-certifications/pre-authorizations, for patients with insurance that requires pre-certifications/pre-authorizations, prior to the provision of care. In addition the Lead will coordinate day-to-day operations of the Insurance Authorization team, assist in training new staff. Promotes and holds employees responsible for ICARE standards.


Responsibilities

  • Utilize vendor based application (tool) to investigate and determine pre-certifications/pre-authorizations status
  • Communicate with insurance companies and patients regarding pre-certifications/pre-authorizations requirements and status to ensure appropriate insurance authorization as secured prior to service.
  • Assists in training new staff, coordinates day-to-day operations, coordinates chart reviews and follows up on phone calls with patients.
  • Answers all phones in office area and directs to appropriate person or resolves issue as well as verifying and receipt of patient’s insurance authorizations and assure all authorizations stay current.
  • Provides assistance as needed to complete departmental reports and analyses.

  • Minimum Requirements

     

    Degree

  • High School Diploma or GED
  •  

    Experience

  • <2 years

  •  

    Preferred Requirements and Additional Job Information

     

    Degree

  • Associate's Degree
  •  

    Supervisor Experience

  • No Experience

  • Benefits Statement

    Note: not all benefits apply to all openings

    -  Comprehensive medical, dental, life insurance, and disability plan options
    -  Pension Plan*/403(b) Plan
    -  401(k) plan
    -  Tuition Assistance
    -  Health Care and Dependent Care Reimbursement Accounts
    -  On-Site Fitness Center (depending on location)
    -  Paid Time Off Program for vacation, holiday and sick time

    *Pension does not apply to Memorial Hospital, Memorial Hospital East, Memorial Medical Group, Alton Memorial or Parkland Health Center


    Legal Statement

    The above information on this description has been designed to indicate the general nature and level of work performed by employees in this position. It is not designed to contain or be interpreted as an exhaustive list of all responsibilities, duties and qualifications required of employees assigned to this job.

     

    Equal Opportunity Employer