Coordinator/Insurance Specialist (Managed Care)

Insurance Specialist (Managed Care)

StoneGate Senior Living

Lewisville, TX

StoneGate Senior Living , a leading provider of Long-Term Care, Skilled Nursing and Rehabilitative Care in Lewisville, TX has an opportunity for an Insurance Specialist with Managed Care Insurance experience to join our team!A rewarding career is waiting for you with a company that specializes in long-term and rehabilitative care! If you are an experienced Insurance Specialist with Managed Care experience, we have the opportunity for you.

As the Insurance Specialist you are responsible for verifying and facilitating insurance authorizations for Skilled Nursing patients. Duties may also include communicating with clinical liaisons, insurance carriers, and Skilled Nursing Facilities. The specialist will assist in the intake process for all patients by receiving referrals, gathering and recording pertinent information, verifying insurance/payor benefits, obtaining preauthorization and completing process to admit inpatients to the Skilled Nursing Facilities.

Come be a part of our mission to provide superior clinical care, rehabilitation, wellness, and supportive services that meet the wants, needs, and expectations of our patients and residents. We offer competitive compensation, health, dental, and vision insurance, company paid life insurance, holiday pay, paid time off, employee appreciation events and much more.

We look forward to you joining our team!

Responsibilities:

• Processes referrals and coordinates admissions of all Skilled Nursing patients in an efficient, responsive manner.
• Coordinates the flow of information through the verification and authorization process and forwards to appropriate departments for the successful completion of admissions.
• Collect and record all insurance/payor information necessary for obtaining authorization to admit Skilled Nursing patients.
• Completes insurance verification process with benefit and billing information.
• Contact patient's insurance to confirm and determine amount of coverage and benefits, deductible due, length of stay and if authorization is required.
• Communicates authorization status electronically and verbally if needed. .
• Maintains open communication with Team Members and Clinical Liaisons to ensure teamwork, cooperation and mutual respect.

Requirements:

• High school diploma or GED certification required.
• Must have Managed Care Insurance experience.
• One year experience with verifying and obtaining authorization of insurances/health-related field preferred.
• Experience in Skilled Nursing authorizations preferred.
• Strong knowledge and understanding of Medicare, Managed Care, HMO/PPO plans and authorization/referral requirements.
• Ability to understand medical terminology.
• Ability to multi-task and prioritize duties.
• Excellent organizational skills.
• Uses a computer proficiently.
• Speaks and communicates English effectively, both in verbal and written format.