The Patient Benefits Advocate works within the Benefits Management Business Unit and is the key stakeholder for verifying insurance coverage for potential new patients (both switch-out and new referrals). This position works Prior Authorization requests and verification rechecks. The successful person will meet or exceed daily/weekly goals and carry out Inogen’s values.
Responsibilities (Specific tasks, duties, essential functions of the job)
Makes outbound calls to insurance companies to verify insurance benefits.
Evaluates insurance coverage in order to determine the policy’s compatibility with our service
Handles request for hospice contracts for our existing patients on service and follows up to completion.
Handles all authorization requests including upfront authorizations needed before a patient comes on service and also new authorizations required for our existing patient population.
Metrics responsibility for # of authorizations sent and received and # of PI/Medicaid verifications complete and # successful and others as assigned.
Handles electronic service requests for PI verifications, PI authorizations, Prior Auth/Precert/Recheck, PI high priorities, and hospice eligibility review (and others as assigned) with appropriate attention to detail and service orientation to meet our service response timeframes.
Has a strong working knowledge of billing procedures, insurance reimbursement procedures and HCPC codes.
Efficiently and accurately verifies, reviews, documents and completes insurance verifications
Ensure Inogen's compliance with all state and federal regulations.
Ensure that appropriate medical records are maintained according to HIPAA guidelines.
Maintain regular and punctual attendance.
Comply with all company policies and procedures.
Assist with any other duties as assigned.
Knowledge, Skills, and Abilities
Excellent verbal and written communication skills required.
Must possess good time management skills, with the ability to prioritize and multi-task.
Must be detail-oriented and analytical to ensure documentation is being assessed properly.
Comprehensive understanding of Medicare and Private Insurance program rules.
Experience in successful verification of all Medical Insurances.
Excellent customer service skills.
Has an ability to work in multiple systems including CRM, Fastrack, Endeavor, and Call on Demand phone system in a fast-paced environment.
Qualifications (Experience and Education)
Associates degree in Communications, Healthcare Management or related field, required.
2 years ‘of Medicare and insurance verification experience preferably for oxygen or HME billing; at least 1 year billing experience, required.
Experience working with Medical Sales personnel, required.
Basic knowledge/proficiency in Microsoft Office, Fastrack and / or Oracle, required.
A combination of training, education and experience that is equivalent to the qualifications listed above and that provides the required knowledge, skills, and abilities.
