Insurance Verification Team Leader
Company Name:
Liberator Medical Supply
I. POSITION PURPOSE
The team lead will coordinate the daily operations of the insurance verification department and is responsible for training, coaching and assisting IV representatives to ensure accurate and efficient insurance verification completion. The person in this role should develop into an insurance expert. The main goal is to complete insurance verifications and pre-authorizations accurately and in a timely manner and to work with the Network Development team to continue to increase the percentage of fully accepted insurance verifications.
II. PRIMARY DUTIES AND RESPONSIBILITIES
1. Supervise team of insurance verification and pre-authorization agents.
2. Develop, implement and maintain current departmental policies and procedures, a quality assurance program and agent productivity metrics and goals.
3. Lead departmental staff development and training programs.
4. Create daily work assignments for IV representatives prioritized by eligibility and exhausted by dates.
5. Ensure all team members are asking & completing all questions on the IV tab in Goldmine and updating account appropriately.
6. Run Goldmine reports daily to review aging orders and exhausted dates to expedite orders as needed.
7. Develop and maintain up-to-date resource guides for agents.
8. Analyze workflow for best practices.
9. Review rejected/denied IVs on a daily basis and take appropriate action.
10. Proactively identify solutions to the companys ability to service patients as an in-network provider.
11. Assist in maintaining insurance database.
12. Work with network development team to communicate health plan contracting opportunities.
13. Respond to all communication promptly and CC manager to ensure accurate information.
14. Desk side coaching to be completed 4 hours per week with team members.
15. Ensure all rushes are handled appropriately and in a timely manner.
16. Complete timely feedback on staff issues that arise and assist in completion of TOD/corrective actions as needed.
17. Review of all new employees work through training period to ensure accuracy.
18. Keep team members focused on work, ensuring they remain in seat with minimal talking.
19. Assign overtime as needed depending on workflow.
20. Immediately inform management when employees call out or leave early.
21. Coordinate regular group meetings to ensure team members are informed on any pertinent information/changes for respective area.
22. Assist in completing 90 day evaluations and regular performance reviews.
23. Meet regularly with new team members to provide status on how they are progressing , if meeting productivity goals and if additional training is needed.
24. Create Saturday schedule.
25. Other job-related duties as assigned.
26.
III. ANCILLARY DUTIES AND RESPONSIBILITIES
1. Create a positive environment in department.
2. Reinforce all Liberator policies and procedures.
3. Maintain confidentiality.
4.
5.
IV. REPORTING RELATIONSHIP RESPONSIBILITIES
_____ No supervisory responsibilities
__x __ Provides work direction only
_____Provides work direction plus has responsibility for hiring, promotions, transfers, performance management, discipline, and discharge.
Positions Supervised: Title:_Insurance Verification Representatives___ Approx. Number in Position:_____13_____
V. MINIMUM REQUIREMENTS OR QUALIFICATIONS
a. Education: Associates degree preferred.
b.
Experience: Working knowledge of health insurance industry and experience working with health plans required (e.g. insurance verification, health plan credentialing, contracting or billing. One to three years experience or a combination of education, training and experience. Supervisory experience preferred.
c. Special Skills and/or Licensure or Certifications required:
1. Working knowledge of health insurance industry.
2. Ability to effectively lead and supervise employees.
3. Excellent written and oral communication skills.
4. Adept at analyzing work flows, streamlining processes and implementing quality assurance measures.
5. Highly proficient level computer skills including MS Word, Excel and Outlook.
6. Highly energetic and self-starteer
7. Maintain good interpersonal skills.
8. Ability to work in fast-paced, self-directed environment.
9. Ability to multi-task activities with shifting priorities.
10. Detail-oriented.
11. Excellent organizational skills.
VI. WORK REQUIREMENTS
1. Ability to work overtime as required.
2. Ability to work flex schedule to ensure adequate coverage in department including nights and weekends.
3.
VII. PHYSICAL REQUIREMENTS
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VIII. WORK ENVIRONMENT
Most tasks are performed in a temperature controlled office environment; however, when not in the temperature controlled environment, tasks may be regularly performed with exposure to adverse environmental conditions such as dirt, dust, pollen, odors, wetness, humidity, rain, fumes, heights, temperature extremes, noise extremes, machinery, vibrations, electric currents, traffic hazards, explosive hazards, toxic agents, radiation, disease, pathogenic substances, vermin or insect infestation.
IX. DISCLAIMER
The above job description is meant to describe the general nature and level of work being performed; it is not intended to be an exhaustive list of all responsibilities, duties, and skills required for this position. The Company officers, mid-level, and entry level management staff may assign additional duties and responsibilities as needed. This job description in no way states or implies that these are the only duties to be performed by the employee occupying this position. Employees will be required to follow any other job-related duties requested by their supervisor in compliance with Federal and State Laws.
Follow HR on Twitter:
www.twitter.com/LibMedJobs
If you are interested in any of the positions listed above you can
complete the On Line application here or
Download Employment Application Here and submit your Resume and Application to:
Or
Fax your Application and resume to: 772-463-3816
Questions?
Call 772-324-3285Estimated Salary: $20 to $28 per hour based on qualifications.
Liberator Medical Supply
I. POSITION PURPOSE
The team lead will coordinate the daily operations of the insurance verification department and is responsible for training, coaching and assisting IV representatives to ensure accurate and efficient insurance verification completion. The person in this role should develop into an insurance expert. The main goal is to complete insurance verifications and pre-authorizations accurately and in a timely manner and to work with the Network Development team to continue to increase the percentage of fully accepted insurance verifications.
II. PRIMARY DUTIES AND RESPONSIBILITIES
1. Supervise team of insurance verification and pre-authorization agents.
2. Develop, implement and maintain current departmental policies and procedures, a quality assurance program and agent productivity metrics and goals.
3. Lead departmental staff development and training programs.
4. Create daily work assignments for IV representatives prioritized by eligibility and exhausted by dates.
5. Ensure all team members are asking & completing all questions on the IV tab in Goldmine and updating account appropriately.
6. Run Goldmine reports daily to review aging orders and exhausted dates to expedite orders as needed.
7. Develop and maintain up-to-date resource guides for agents.
8. Analyze workflow for best practices.
9. Review rejected/denied IVs on a daily basis and take appropriate action.
10. Proactively identify solutions to the companys ability to service patients as an in-network provider.
11. Assist in maintaining insurance database.
12. Work with network development team to communicate health plan contracting opportunities.
13. Respond to all communication promptly and CC manager to ensure accurate information.
14. Desk side coaching to be completed 4 hours per week with team members.
15. Ensure all rushes are handled appropriately and in a timely manner.
16. Complete timely feedback on staff issues that arise and assist in completion of TOD/corrective actions as needed.
17. Review of all new employees work through training period to ensure accuracy.
18. Keep team members focused on work, ensuring they remain in seat with minimal talking.
19. Assign overtime as needed depending on workflow.
20. Immediately inform management when employees call out or leave early.
21. Coordinate regular group meetings to ensure team members are informed on any pertinent information/changes for respective area.
22. Assist in completing 90 day evaluations and regular performance reviews.
23. Meet regularly with new team members to provide status on how they are progressing , if meeting productivity goals and if additional training is needed.
24. Create Saturday schedule.
25. Other job-related duties as assigned.
26.
III. ANCILLARY DUTIES AND RESPONSIBILITIES
1. Create a positive environment in department.
2. Reinforce all Liberator policies and procedures.
3. Maintain confidentiality.
4.
5.
IV. REPORTING RELATIONSHIP RESPONSIBILITIES
_____ No supervisory responsibilities
__x __ Provides work direction only
_____Provides work direction plus has responsibility for hiring, promotions, transfers, performance management, discipline, and discharge.
Positions Supervised: Title:_Insurance Verification Representatives___ Approx. Number in Position:_____13_____
V. MINIMUM REQUIREMENTS OR QUALIFICATIONS
a. Education: Associates degree preferred.
b.
Experience: Working knowledge of health insurance industry and experience working with health plans required (e.g. insurance verification, health plan credentialing, contracting or billing. One to three years experience or a combination of education, training and experience. Supervisory experience preferred.
c. Special Skills and/or Licensure or Certifications required:
1. Working knowledge of health insurance industry.
2. Ability to effectively lead and supervise employees.
3. Excellent written and oral communication skills.
4. Adept at analyzing work flows, streamlining processes and implementing quality assurance measures.
5. Highly proficient level computer skills including MS Word, Excel and Outlook.
6. Highly energetic and self-starteer
7. Maintain good interpersonal skills.
8. Ability to work in fast-paced, self-directed environment.
9. Ability to multi-task activities with shifting priorities.
10. Detail-oriented.
11. Excellent organizational skills.
VI. WORK REQUIREMENTS
1. Ability to work overtime as required.
2. Ability to work flex schedule to ensure adequate coverage in department including nights and weekends.
3.
VII. PHYSICAL REQUIREMENTS
(
VIII. WORK ENVIRONMENT
Most tasks are performed in a temperature controlled office environment; however, when not in the temperature controlled environment, tasks may be regularly performed with exposure to adverse environmental conditions such as dirt, dust, pollen, odors, wetness, humidity, rain, fumes, heights, temperature extremes, noise extremes, machinery, vibrations, electric currents, traffic hazards, explosive hazards, toxic agents, radiation, disease, pathogenic substances, vermin or insect infestation.
IX. DISCLAIMER
The above job description is meant to describe the general nature and level of work being performed; it is not intended to be an exhaustive list of all responsibilities, duties, and skills required for this position. The Company officers, mid-level, and entry level management staff may assign additional duties and responsibilities as needed. This job description in no way states or implies that these are the only duties to be performed by the employee occupying this position. Employees will be required to follow any other job-related duties requested by their supervisor in compliance with Federal and State Laws.
Follow HR on Twitter:
www.twitter.com/LibMedJobs
If you are interested in any of the positions listed above you can
complete the On Line application here or
Download Employment Application Here and submit your Resume and Application to:
Or
Fax your Application and resume to: 772-463-3816
Questions?
Call 772-324-3285Estimated Salary: $20 to $28 per hour based on qualifications.
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