Authorization / Billing Coordinator (Remote)

About Us

Ennoble Care is a mobile primary care, palliative care, and hospice service provider with patients in New York, New Jersey, Maryland, DC, Virginia, Oklahoma, Kansas, Pennsylvania, and Georgia. Ennoble Care's clinicians go to the home of the patient, providing continuum of care for those with chronic conditions and limited mobility. Ennoble Care offers a variety of programs including, remote patient monitoring, behavioral health management, and chronic care management, to ensure that our patients receive the highest quality of care by a team they know and trust. We seek individuals who are driven to make a difference and embody our motto, "To Care is an Honor." Join Ennoble Care today! Description: The Authorization / Billing Coordinator is responsible for the timely billing and resolution of claims, with a focus on authorizations. Serving as a subject matter expert of authorizations, including but not limited to, obtaining authorizations, reporting on authorizations, resolving claims denials related to authorizations, and contributing to process improvement related to authorizations. Authorization: Authorization Coordinator manages the insurance approval process for hospice services, ensuring all levels of care including initial admissions and ongoing services are approved by payers to prevent denials. Verify benefits, submit clinical documentation for authorization and communicate with insurers to ensure compliance with Medicaid and private payor regulations.

Responsibilities

• Verify insurance eligibility and benefits for new and current patients including Medicare, Medicaid and private insurance at beginning of each month.
• Submit Medicaid documentation for Hospice enrollment and lock-in with all the formal NOE and Physician certification to the state Medicaid agency or its designated Portal.
• Track authorization in the electronic medical record (EMR) system ensuring all clinical documentation meets payer requirements
• Act as a liaison between the clinical staff, billing, families, and insurance companies.
• Follow up on pending authorizations and appeal denied claims.
• Experience in Availity Portal and all commercial insurance portals to streamline eligibility verification, prior authorizations, and complete other secure administrative tasks.
• Runs daily reports to identify authorization nearing expiration to proactively initiate extensions and Perform re-authorization and eligibility checks in a timely manner before the expiration of current approved hospice benefit periods.

Billing: The Billing Coordinator is responsible for the timely billing and resolution of claims. Serving as a subject matter expert of claims resolution, including but not limited to, the resolution of charge rejections and charge denials, submission of appeals, and follow-up with payors on outstanding accounts receivables.

Responsibilities

• Resolve claims rejections and denials in work queues as assigned
• Resolve outstanding claims based on an accounts receivable report, including but not limited to, accessing payor portals, calling the payors for status updates or reprocessing of claims, payment posting
• Submit appeals to payors for non-payment of claims as needed
• Identify areas of opportunities to improve the claims and accounts receivable processes and ultimately clean claim payments
• Identify and communicate any potential claims issues that could result in loss of revenue
• Communicate with providers and other team members to resolve any billing/claims/accounts receivable issues
• Participate in team meetings and communications
• Perform assigned duties in a compassionate manner in accordance with the mission/values of Ennoble Care
• Perform specific assignments as directed by the Revenue Cycle Director

Qualifications:

• Minimum 3 years' experience in claims and/or accounts receivables for physician services
• Preferred experience with Waystar
• Detail oriented, organized and able to multitask
• Represents the organization in a positive and professional manner
• Comply with all organizational policies regarding ethical business practices
• Maintain regulatory requirements, including all federal, state, local regulations and accrediting organization standards
• Understand Medicare, Medicaid and Third-party rules, regulations and billing codes
• Proficient in all Microsoft Office applications as well as medical office software
• Strong interpersonal and organizational skills

Able to work in a fast-paced environment Starting Salary $50,000 (remote position) #tan Full-time employees qualify for the following benefits: Apply To This Job