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Eligibility and Authorization / Medical Records Coordinator

Company: VNA Health
Location: Santa Barbara
Posted on: November 12, 2021

Job Description:

Job Description Summary

Under general supervision, verifies insurance eligibility and secures initial authorization and/or certification for all insurances for home health and hospice patients and processes and maintains accurate patient medical records ensuring timely orders processing and performing records-related duties such as filing, indexing, and record audits following HIPAA protocols. Respects and promotes the mission, vision and values of VNA Health.

Essential Job DUTIES AND Responsibilities

  • Interacts with the insurance companies and IPA's to verify eligibility and benefits for all home health and hospice patients.
  • Communicates with clinical staff to ensure they understand the patient's authorization and can communicate benefit information to patients for home health.
  • Sends Notification of benefits and Financial Responsibility information to Hospice patients when verification indicates the patient has co-insurance amounts due.
  • Documents eligibility and authorization in accordance with departmental policies.
  • Perform all daily medical records functions, including chart assembly, reports, audits, indexing, and orders processing in accordance with Agency policies and department procedures.
  • Follow Medical Records protocols and follow Agency policies and procedures to ensure medical records are maintained in compliance with state, federal, and accreditation requirements.
  • Fulfill authorized medical record requests.
  • Complete administrative record audits following patient admission and discharged to ensure all documents are complete.
  • Protect the confidentiality of patient and organization information through effective controls of medical records
  • Other duties as assigned by the Patient Accounting & Medical Records Manager.
    The above statements are only meant to be a representative summary of the major duties and responsibilities performed by incumbents of this job. The incumbents may be requested to perform job-related tasks other than those stated in this description.

    Position Qualifications
    • High school graduate or equivalent.
    • Excellent written/verbal skills.
    • Exceptional data entry skills.
    • Experience with Billing systems, including system upgrades and configuration.
    • Knowledge of alpha/numerical filing system.
    • Ability to maintain confidentiality.
    • Knowledge of CPT,ICD-9, and Revenue coding.
    • At least 3 years of insurance eligibility and benefits experience.

      Physical Qualifications
      • Ability to lift 50 lbs.
      • Ability to push/pull 50 lbs.
      • Ability to stoop, bend and squat.
      • Ability to walk up one flight of stairs.
      • Ability to walk one mile.
      • Ability to sit for one hour, minimum.
      • Visual and audio acuity.
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Keywords: VNA Health, Santa Barbara , Eligibility and Authorization / Medical Records Coordinator, Healthcare , Santa Barbara, California

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