Medical Benefits and Eligibility Verification for Post-Acute/LTC patients

Seeking someone with experience as a medical practice manager or benefits specialist to complete medical coverage eligibility and benefits verification for a high volume post-acute care provider group. Must have direct experience and understanding of differences in Medicare Part B, Med Advantage, Medicare/Medicaid HMO, and other insurers/plans seen in this patient population. Must have experience utilizing NGS Connex, Noridian, Availity, etc. Experience with post-acute facility EMRs (PCC, Matrix, etc) preferred. Ideally has familiarity with insurer dynamics in IL/IN as well as CA (e.g. IPA, closed managed plans, etc).

Deliverables:
1) High volume verification (50-200 pts) of primary medical benefits insurer, active status/effective date, preventive service eligibility (e.g. AWV), and mental health services eligibility/pre-authorization requirements (e.g. psychotherapy). Information to be populated into an Excel-based template.

2) Lower volume/periodic verification of preventive service eligibility (e.g. AWV) and mental health service eligibility/pre-authorization requirements (e.g. psychotherapy).

Engagement will start with a trial project with opportunity for ongoing/steady work. Please only apply if open to an ongoing engagement.

We are an innovative organization focused on patient centered care and raising the standard of care in the post-acute setting.
About the recuiter
Member since May 20, 2018
Saurabh Sharma
from Csongrad, Hungary

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