Option Care Benefits Coordinator in Los Angeles, California
Option Care is a healthcare services company that at its core delivers high quality, cost effective infusion services through trusted partnerships across the healthcare system, resulting in outcomes that make a positive difference in people’s lives.
Job Description Summary:
Responsible for performing the appropriate procedures to verify patient eligibility, coordinate benefits, run test claims and determine patient coverage/responsibility for services and testing and implementation of new plan business.
Performs Insurance Verification of benefit coverage on all of patient's insurance plans for each service being provided.
Obtains and documents in the system all information related to coinsurance, copay, deductibles, authorization requirements, etc.
Creates documentation required to service the patient per policy and payer guidelines.
Determines estimated patient financial responsibility using insurance verification information and payer contracts and/or self-pay guidelines.
Obtains initial authorization prior to admitting the patient for all services for any insurance plan that has authorization requirements.
Obtains reauthorization as necessary, reviews physician orders from pharmacy to determine if authorization is required on changes / additions to therapy for patients that are already on service.
Basic Education and/or Experience Requirements: High School Diploma or equivalent.
Basic Qualifications & Interests:
Basic level skill in Microsoft Excel (for example: opening a workbook, inserting a row, selecting font style and size, formatting cells as currency, using copy, paste and save functions, aligning text, selecting cells, renaming a worksheet, inserting a column, selecting a chart style, inserting a worksheet, setting margins, selecting page orientation, using spell check and/or printing worksheets).
Basic level skill in Microsoft Word (for example: opening a document, cutting, pasting and aligning text, selecting font type and size, changing margins and column width, sorting, inserting bullets, pictures and dates, using find and replace, undo, spell check, track changes, review pane and/or print functions).
Preferred Qualifications & Interests: Previous Infusion Medical Billing/Collections or Intake/Admissions Experience.
This job description is to be used as a guide for accomplishing Company and department objectives, and only covers the primary functions and responsibilities of the position. It is in no way to be construed as an all-encompassing list of duties.
Option Care subscribes to a policy of equal employment opportunity, making employment available without regard to race, color, religion, national origin, citizenship status according to the Immigration Reform and Control Act of 1986, sex, sexual orientation, gender identity, age, disability, veteran status, or genetic information.
Option Care is a leading provider of home and alternate treatment site infusion services. With a staff of more than 1,700 clinical experts – including specially trained infusion nurses, infusion pharmacists and registered dietitians – Option Care treats patients with a wide range of acute and chronic conditions. Comprehensive therapy management programs are offered for patients with nutrition disorders, bleeding disorders and heart failure, as well as those needing immunoglobulin (IG) therapy and anti-infective therapy. Option Care is able to provide services to 92% of the nation’s population through more than 90 infusion pharmacies and 100 alternate treatment sites across the country.