Find more Architecture Remote Jobs posted recently Worldwide

Required Engineering,Computer Engineering,Software Architecture freelancer for Health Insurance Clearinghouse workflow and understanding job

Posted at - Jul 18, 2021

Toogit Instant Connect Enabled


I need to create a very detailed report that will answer the following questions. It is very important to identify all the major payors and to understand how a provider can verify and authorize through the EHR versus a standalone system. For example is the process to verify insurance with BCBS of TX different than BCBS of TN

Document the process flow for a patient calling or visiting an office and having the insurance verification and authorization done prior to the visit.
- Also understand if it is possible for the patient to understand what their bill will be upon checkout based on the verified and authorized benefits.
- A practice will populate the insurance/verification screens within existing ehr (or Soteria) and connect to the identified payor to verify and/or authorize the copay, payment, or procedure payment within the same system. (don't want to leave the existing system)
- Understand the information that is available through the payor to populate the insurance and verification screens in the Soteria (or existing system)
- Communicate and confirm to Soteria the data available in order for developers to create screens to capture the data.
- How to connect through HL7 (version being used) or HL7 FHIR, Json or what other means
- Are the various payors using different versions of HL7 or other connectivity
- Do the same payors use different systems, versions, connections? For example does UnitedHealth TN use a different System than United Health TX. If connected to one are we connected to all the systems?
- Is each payor in each state its own company and therefore use different systems? For example maybe United Health is the same across the US, but BCBS is different
- Is there a cost to connect to the payor system or will the payor pay to get connected
- Understand what an office needs to do to authorize a procedure. What is the workflow and is it the same in all offices? It is understood that a "message" is sent from a task list in order to get the procedure complete
- Are there any third party systems available that only do validation and authorization without selling a complete system?

About the recuiterMember since Aug 29, 2017 Adele
from Hazafon, Israel

Skills & Expertise Required

Engineering Computer Engineering Software Architecture 

Candidate shortlisted and hiredHiring open till - Jul 18, 2022

Work from Anywhere
40 hrs / week
Fixed Type
Remote Job
$313.06
Cost

Looking for help? Checkout our video tutorial
How to search and apply for jobs

How to apply? Do you have more questions about the Job?
See frequently asked questions


Apply on more work from home jobs posted in Architecture category.


Related Jobs


Latest In Engineering Jobs


Latest In Computer Engineering Jobs


Latest In Software Architecture Jobs