Apria Healthcare

Payer Change Specialist

Requisition ID
2020-9599
# of Openings
10
Category
Revenue Management
Location : Location
US-TN-Jackson
Full/Part Time
Full-time

Job Summary

With over 300 locations across the US, Apria Healthcare’s mission is to improve the quality of life for our 1.8 million patients at home by providing home respiratory services and select medical equipment to help them sleep better, breathe better, heal faster, and thrive longer. Additional information can be found at www.apria.com.

 

JOB SUMMARY

The Payer Change Specialist processes patient changes in insurance.

 

ESSENTIAL DUTIES AND RESPONSIBILITIES

  • Ensures that payor changes are completed, payment is guaranteed prior to delivery and revenue is posted appropriately.
  • Verifies that the correct product and payor are used for the service, equipment, and therapy. Ensures that the correct allowable is recorded in accordance with the contract.
  • Contacts payors (online or by phone) to verify insurance coverage and eligibility requirements.
  • Obtains verbal / written authorization for medical treatment from appropriate sources.
  • Verifies insurance information for accuracy and completeness and resolves discrepancies as necessary.
  • Research and resolve accounts and identify gaps between current and former payor requirements and existing billing documentation. Ensure account bills correctly for open and future invoices
  • Answers inbound calls from patients with updates to their insurance
  • Coordinates and contacts patients, branches and referrals to obtain required testing as required by the new payor.
  • Notifies and schedules new testing for the customer.
  • Documents account activity in ACIS and other systems, as required
  • Complies with all regulatory compliance areas, policies and procedures and “best practices”.
  • Performs other duties as required.

Minimum Required Qualifications

MINIMUM REQUIRED QUALIFICATIONS

 

Education and/or Experience

  • High school diploma is required.
  • One year of related work experience is required.
  • One year of medical billing experience is required.

 

Certificates, Licenses, Registrations or Professional Designations

  • N/A

 

SKILLS, KNOWLEDGE AND ABILITIES

  • Must be familiar with payor contractual requirements.
  • Business Acumen
  • Problem Solving/Analysis
  • Communication Proficiency
  • Personal Effectiveness/Credibility

 

Computer Skills

  • Basic skills in Access, Excel, PowerPoint, MS Project, Visio, Word

Language Skills

  • English (reading, writing, verbal)

 

Mathematical Skills

  • Basic level mathematical proficiency, with a strong ability to understand, interpret and develop spreadsheet data.

 

Other Skills

  • N/A

 

PHYSICAL DEMANDS

This is a stationary position that requires frequent sitting or standing, repetitive wrist motions, grasping, speaking, listening, close vision, color vision, and the ability to adjust focus.  It also may require occasional lifting, carrying, walking, climbing, kneeling, bending/stooping, twisting, pulling/pushing, walking, bending, stooping, and reaching above the shoulder.  Employees in this position must be physically able to efficiently perform the essential functions of the position. Reasonable accommodations will be provided to assist or enable qualified individuals with disabilities to perform the essential functions of the position, upon request.

 

WORK ENVIRONMENT

Work is performed in an office setting with exposure to moderate noise. 

 

TRAVEL

Occasional travel as required.

 

OTHER INFORMATION

The essential duties and responsibilities, physical requirements, and work environment described above are representative of those typically required for this position but may vary depending on staffing and business needs at specific locations. The inclusion or omission of a specific duty or physical requirement is, therefore, not determinative of whether that function is essential to a specific individual’s position.

 

Join the Apria team for a rewarding opportunity in healthcare!  Competitive pay rates with cash incentives and full benefit packages available, including health, dental, vision, disability and 401(k).

 

Apria Healthcare is committed to hiring veterans and military spouses. 

EEO Statement

As an EOE/AA employer, Apria Healthcare is committed to providing all applicants and employees with equal access to employment opportunities, regardless of sex, race, age, color, national origin, disability, pregnancy, religion, genetic information, sexual orientation, transgender status, gender identity, marital status, veteran status, or any other characteristic protected by federal, state, or local law.  Apria Healthcare shall abide by the requirements of 41 CFR 60-300.5(a) and 60-741.5(a). These regulations prohibit discrimination against qualified individuals on the basis of protected veteran status or disability, and require affirmative action by covered prime contractors and subcontractors to employ and advance in employment qualified protected veterans and individuals with disabilities. AA/EOE, M/F/Disability and Vet

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