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Date Posted: 10/04/2019
Location: Chambersburg, PA 17202
Company: SpiriTrust Lutheran
Job Type: Full Time

Basic Qualifications
 
Education/Training:  A high school diploma or equivalent.
 
Skill(s):  Proficient reading, writing and grammatical skills; proficient in interpersonal relations and communication skills, including pleasant telephone manner and speaking voice; ability to work independently and to establish and maintain effective working relationships; working knowledge of computer operations and ability to learn specialized industry applications.
 
Experience:  A minimum of one (1) year of experience in healthcare third party reimbursement system.  A minimum of six (6) months of experience using computer systems normally required.
 
General Responsibilities
 
Responsible for verifying insurance coverage for SLHCH clients; coordinating work within the department, as well as with other departments; complying with operating policies and procedures and regulatory requirements; communicating with appropriate personnel; responding to inquiries or requests for information; maintaining appropriate records and providing assigned reports.
  
Essential Duties
 
Supports the mission of SpiriTrust Lutheran Home Care & Hospice which is to answer Christ’s call by providing health care and related services to those who are striving to achieve their highest possible level of independence, quality of life, health and comfort.

 
Supports the mission of SpiriTrust Lutheran, which is witness to the Gospel of Jesus Christ, providing exceptional health, human and senior living services by supporting persons in achieving an optimal quality of life.

 
Assures accuracy of client insurance information and verification of benefit coverage with insurance companies.

 
Verifies Medicare eligibility and coverage related to SLHCH services.

 
Acts as a resource person for questions about potential Medicare Secondary Payor situations.

 
Understands contents of contracts relating to services provided to clients. 
 

Researches and disseminates information regarding commercial insurance coverage for all incoming referrals as follows:
 

Verifies eligibility and coverage related to SLHCH services.
 
Obtains initial authorization for services if applicable.
 
Coordinates secondary coverage for services.
 
Communicates information to staff and clients both verbally and in writing related to resources for payment for services.

Sends confirmation letters to clients to verify details of insurance coverage.

Responds to clients and staff as appropriate.

 
Processes Fee Adjustment applications for all specified clients in a timely manner as follows: 
 

Explains Application for Fee Adjustment, if applicable, to client and/or client’s responsible party.
 
Sends Application for Fee Adjustment in accordance with established procedure and coordinates follow-up with Billing Specialist.

 
Verifies Medical Assistance eligibility for both Pennsylvania and Maryland.

 
Participates with supervisor in establishing specific goals for the department; implements strategies to achieve these goals.

 
Provides coverage for Front Desk Phone Attendant as necessary

 
Cooperates with, participates in and supports the adherence to all internal policies, procedures and practices, laws and regulatory requirements.

 
Works harmoniously with others.

 
Coordinates specific work tasks with other personnel within the department as well as with other departments in order to ensure the smooth and efficient flow of information.

 
Communicates with his/her supervisor, other supervisors, community relations coordinators and appropriate staff in order to integrate activities. 
 

Responds to inquiries relating to his/her particular area, or to requests from other personnel, clients, etc. within given time frames and within established policy.

 
Maintains appropriate records and provides assigned reports.

 
Supports and advances the Lean philosophy in all endeavors.