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Lead Intake & Insurance Verification Coordinator

Orlando, Florida Apply Now Job ID 1175738 Category Health Insurance Operations Organization Envolve Schedule Full-time

Position Purpose: Obtain and verify complete insurance information, including the prior authorization process, copay assistance and coordination of benefits

  • Assist with managing the work load to ensure that referrals and orders are handled in a timely manner
  • Monitor each queue through various reports and redistribute work as appropriate
  • Serve as the point of contact for key physicians’ offices and coordinate referrals with the sales team during insurance verification process
  • Serve as the point of contact or designated rep for contracted payors
  • Serve as the point of contact or designated rep for special pharma accounts working with their HUB’s and collecting and documenting pharma
  • specific data in the system
  • Obtain and verify insurance eligibility for services provided and document complete information in system
  • Perform prior authorizations as required by payor source, including procurement of needed documentation by collaborating with physician offices and insurance companies
  • Collect any clinical information such as lab values, diagnosis codes, etc.
  • Determine patient’s financial responsibilities as stated by insurance
  • Configure coordination of benefits information on every referral
  • Ensure assignment of benefits are obtained and on file for Medicare claims
  • Bill insurance companies for therapies provided
  • Document all pertinent communication with patient, physician, insurance company as it may relate to collection procedures
  • Identify and coordinate patient resources as it pertains to reimbursement, such as copay cards, third party assistance programs, and manufacturer assistance programs
  • Handle inbound calls from patients, physician offices, and/or insurance companies

  • Qualifications:

    Education/Experience: High school diploma or equivalent. 3+ years of medical billing, insurance verification experience, call center, and/or previous experience as a lead managing cross functional teams required. Experience with payors and prior authorization requirements and strong customer service skills preferred.

    Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

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