What we're looking for

We're working to deliver exercise and wellness for the older adult, initially focusing on cardiovascular disease. Our team consists of mission-driven clinicians, engineers, and scientists attacking this problem using evidence-based research and guidelines.

We are seeking an experienced care coordination and insurance verification professional to provide a delightful patient experience with clinical knowledge and passion for the heart health space. You will help provide recovery and preventative efforts by facilitating a thorough and meaningful beginning to their Recora journey.

Responsibilities

• Provide estimates for insurance eligibility including copays, coinsurance, or out of pocket costs
• Obtain patient responsibility, research payer coverage criteria and any required prior authorization requirements
• Communicate insurance findings with relevant parties internally and externally
• Support other activities in the revenue cycle as needed
• Ensure timely follow-up response for patients that have insurance questions
• Anticipate patient challenges and effectively answer questions/gaps in understanding of insurance benefits
• Utilize online systems, phone communication, and other resources to verify eligibility and benefits, determine extent of coverage, and secure pre-authorizations before scheduling patients
• Address incoming billing questions from patients and/or internal team members
• Educate patients and family members about Recora's program including the benefits of cardiac recovery and patient journey
• Perform insurance verification of benefits and capture information in the patient records
• Thoroughly document correspondence with insurance, clients, and patients in the patient records
• Maintain records and follow up for patients
• Prepares and sends prior authorizations to insurance when required
• Document insurance, provider, and clinical updates regarding patient health
• Calculate patient responsible balances based on coverage findings and documents in the patient records in Zendesk

Your Past Experience

• 1-2 years of call center operations, healthcare enrollment, sales experience (cardiology a plus), billing or collections
• 2 years of Epic experience
• 3 years of insurance benefit verification experience
• Comfort with technology, including Google Suite and CRM software (Zendesk)
• 1-3 years of care management/patient coordination experience in a clinical setting (cardiology a plus)
• Experience with CPT and ICD coding, preferred
• 1-3 yrs of insurance portal experience, including NAVINET, AVAILITY, NORIDIAN, MyCGS, TRICARE, Etc.

Other

• Hourly rate is $22
• Minimum of 30 hours a week. 40 hours a week, preferred
• Multilingual a plus!
• Strong knowledge of, and experience working withmedical insurance, including Medicare, Medicare Advantage plans, and other commercial insurance products

Note: This is a 1099 Contractor position only.