About the Role
The Insurance and Benefits Coordinator at Elmwood Healthcare is responsible for managing all aspects of insurance verification, authorization, and billing processes to ensure efficient and timely reimbursement for home health services provided. This role requires a strong understanding of insurance policies and procedures, excellent communication skills, and the ability to work collaboratively with healthcare providers and insurance companies.
Department | Financial Operations > Accounts Receivable (AR) |
Status / Type | Full Time (40-Hours / Week) |
Schedule | Monday through Friday; 8:00 A.M. to 4:30 P.M. |
Environment | Office-Based |
Key Responsibilities:
Insurance Verification:
Verify patients' insurance coverage and benefits prior to service initiation.
Communicate coverage details, co-pays, deductibles, and out-of-pocket expenses to patients and their families.
Authorization and Pre-certification:
Obtain necessary authorizations and pre-certifications from insurance companies for home health services.
Ensure compliance with insurance guidelines and timely submission of authorization requests.
Billing and Claims Processing:
Prepare and submit accurate claims to insurance companies, Medicare, Medicaid, and other payers.
Monitor claim status and follow up on unpaid or denied claims.
Resolve billing discrepancies and resubmit claims as necessary.
Documentation and Record Keeping:
Maintain comprehensive and up-to-date records of insurance verifications, authorizations, and billing activities.
Ensure all documentation meets regulatory and compliance standards.
Communication and Collaboration:
Serve as a liaison between healthcare providers, patients, insurance companies, and other stakeholders.
Educate patients on insurance coverage, billing processes, and financial responsibilities.
Quality Assurance and Compliance:
Stay current with changes in insurance regulations, policies, and procedures.
Adhere to HIPAA guidelines and maintain confidentiality of patient information.
Qualifications
High School Diploma or Equivalent (Required).
Certification in Medical Billing and Coding (Preferred).
Proven experience as an Insurance Coordinator, preferably in a home health care setting (Preferred).
Knowledge of medical insurance policies, procedures, and billing practices.
Familiarity with Medicare, Medicaid, and commercial insurance plans.
Strong analytical and problem-solving skills.
Excellent verbal and written communication skills.
Ability to prioritize tasks and manage time effectively in a fast-paced environment.
Proficiency in electronic medical records (EMR) and billing software.
Elmwood Healthcare - Home Health
Elmwood Healthcare is looking for a committed, eager, passionate and experienced professional to join the team of highly-skilled individuals within our community-based health system.
Elmwood Healthcare's Home Health Division, Elmwood Home Care, is a multi-setting Medicare-Certified, dual-program Joint Commission accredited organization, providing both skilled medical home health care and non-skilled home care services to hundreds of communities by way of Agency branch locations in Rhode Island and Massachusetts.
Our committment to quality and focus on enhanced, specialized care has been defining in the organic evolution of Elmwood Home Care, and our attention to high-demand and high-acuity care in the home-based setting has allowed us to deliver our reimagined home health care services to thousands of patients already. This focus, in areas such as home-infusion therapy, advanced wound care and wound management, home-safety and falls prevention, to name a few, have been met with enormous success and positive clinical outcomes for our patients and their families.
Such unique and hands-on approaches to clinical care and home-based community health management work to capture Elmwood Healthcare's system-wide emphasis on the key ideals that we embody, including: Innovation; Individual patient-centered approaches to a wide-range of specialty, chronic and acute care; Health equity and access to promote longevity, sustainability and the provision of high-quality care in community-based settings, allowing our community populations to safely and effectively age in place; And, at the forefront, the highest standards in the provision of high-quality community-based care.
Driven by a passion for community health, Elmwood Healthcare believes in the ways that community-based healthcare positively impacts our communities. Through the delivery of unmatched care, a culture of safety and respect, and endless opportunity for personal, professional and career development, we are committed to igniting change within the healthcare industry. Our focus and goal is to bring care back to the patient, and bring healthcare professionals back to doing what they love- caring for others.
Elmwood Healthcare, at large, supports and cares for communities by providing compassionate, innovative and personalized care. Through a comprehensive, community-based systems approach, we are committed to the delivery of the highest-quality of patient-centered care. Through this model, we maximize patient success and reduce hospital re-admissions to promote higher-rates of successful outcomes. For our patients, this is all possible when care is delivered in the comfort of their own home.
The dedication to each patient Elmwood Healthcare cares for goes well beyond the scope of intermittent services, with primary focus on communication, continuity and growth. Holding ourselves, our teams and our partners in the community accountable to the highest standards of care and operational integrity, Elmwood Healthcare champions the promotion of health-equity, access to viable and necessary community resources and enhanced equal opportunities for each patient and each member of our team alike.
Through these core ideals, Elmwood Healthcare places emphasis on personal and professional growth, skill acquisition through continuous hands-on training, and long-term career development within the organization to promote the development of our professionals, thereby supporting and enhancing integrated access to high quality care for our patients and their families.
Our standards are modeled to mirror those of federally-supported accrediting bodies and lead us to our commitment to ongoing and absolute compliance with local, state and federal regulations, allowing Elmwood Healthcare to further promote large scale positive impacts on our communities.
The execution of our philosophies and missions solidify Elmwood Healthcare as a pioneer community-based healthcare innovation. Pillared by models that emphasize patient-centered approaches, our goals focus on upholding quality, safety, access and equity in healthcare. Elmwood Healthcare emboldens an evolving and limitless vision of opportunity that seeks to continually empower our patients and families, our team-members and our partners in the communities that we serve.