[Hiring] Lead Intake & Insurance Verification Coordinator @Centene Corporation

Role Description

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

• Obtain and verify complete insurance information, including the prior authorization process, copay assistance and coordination of benefits.
• Assist with managing the work load to ensure that referrals and orders are handled in a timely manner.
• Monitor each queue through various reports and redistribute work as appropriate.
• Serve as the point of contact for key physicians’ offices and coordinate referrals with the sales team during insurance verification process.
• Serve as the point of contact or designated rep for contracted payors.
• Serve as the point of contact or designated rep for special pharma accounts working with their HUB’s and collecting and documenting pharma-specific data in the system.
• Obtain and verify insurance eligibility for services provided and document complete information in system.
• Perform prior authorizations as required by payor source, including procurement of needed documentation by collaborating with physician offices and insurance companies.
• Collect any clinical information such as lab values, diagnosis codes, etc.
• Determine patient’s financial responsibilities as stated by insurance.
• Configure coordination of benefits information on every referral.
• Ensure assignment of benefits are obtained and on file for Medicare claims.
• Bill insurance companies for therapies provided.
• Document all pertinent communication with patient, physician, insurance company as it may relate to collection procedures.
• Identify and coordinate patient resources as it pertains to reimbursement, such as copay cards, third party assistance programs, and manufacturer assistance programs.
• Handle inbound calls from patients, physician offices, and/or insurance companies.
• Perform other duties as assigned.
• Comply with all policies and standards.

Qualifications

• High school diploma or equivalent.
• 3+ years of medical billing, insurance verification experience, call center, and/or previous experience as a lead managing cross functional teams required.
• Experience with payors and prior authorization requirements.

Requirements

• Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future.
• Qualified candidates must be able to work 12PM-9PM EST as well as overtime and weekend hours as needed.

Benefits

• Competitive pay.
• Health insurance.
• 401K and stock purchase plans.
• Tuition reimbursement.
• Paid time off plus holidays.
• Flexible approach to work with remote, hybrid, field or office work schedules.
• Total compensation may also include additional forms of incentives.
• Benefits may be subject to program eligibility.