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Raintree Systems · 1 day ago

Authorization & Eligibility Coordinator (Healthcare/SaaS/EHR)

United States

Full-time

Remote

New Grad, Entry Level

Raintree Systems is a healthcare technology company seeking an Authorization & Eligibility Coordinator to ensure quality and timely benefit verifications and manage client enrollment and credentialing. The role involves verifying patient health insurance benefits, submitting authorizations, and communicating with clients regarding eligibility issues.

Computer Software

Responsibilities

Responsible for the verification and eligibility of patient health insurance benefits via external insurance web portals or over the phone

Responsible for authorization submission as needed based on patient's health insurance requirements via external insurance web portal or over the phone

Assures all insurance information has been completely and accurately obtained. Documents all pertinent insurance eligibility information

Documents information given or received to support actions taken on insurance issues

Assures all authorization information is documented completely and accurately for claims processing

Review, evaluate and assist in creating processes and workflows for future benefit and authorization teams

Monitor authorization exceptions to ensure timely claim billing

Communicate with clients regarding authorization or eligibility issues or trends

Assist external departmental personnel in strategically critical issues as the need arises

Qualification

Eligibility verificationAuthorization submissionMedical billing knowledgeSoftware configurationClient communicationCustomer service focusVerbal communicationWritten communicationOrganizational skills

Required

High School Diploma, GED, or equivalent work experience

Requires consistent judgment using software and industry expertise to analyze client needs and processes and then exercise discretion regarding how to configure and customize the solution, which not only includes Raintree's product but also a variety of vendor partners (clearinghouses, payment processors, faxing solution providers, patient payment processors, Revenue Management services, etc) which are only brought into play as needed / appropriate

Ability to teach end users in the solution's optimal use, which is different for every client

Requires knowledge of multiple medical specialties and the rules regarding their billing and documentation (which vary by state and sometimes by county within a state)

Understanding of accounting principles governing corporate reporting, teaching - including developing custom training plans and documentation, understanding of software engineering / development processes

Well-developed verbal, listening and phone communication skills

Good written communication skills with the ability to write routine correspondence

Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals

Ability to define problems, collect data, establish facts, and identify trends

Ability to exercise good judgment and escalate issues appropriately

Strong organizational skills and ability to execute manual detailed tasks

Strong customer service focus and commitment

Ability to establish and maintain effective working relationships within the team

Ability to work well with diverse personalities

Tactful, mature and flexible

Ability to work remotely. Strong video conferencing etiquette

Benefits

Remote Work/Work From Home

Paid Time Off/11 Paid Holidays/Year-End Holiday Break

Health, Dental, Vision, HSA/FSA

401K with Company Match

Disability & Life Insurance

Employee Assistance Program

Paid Parental Leave.

Company

Raintree Systems

Raintree is the rehabilitation and physical therapy software of choice for enterprise and large therapy provider organizations, managing more than 50 million patient visits annually across 8,500+ therapy clinics nationwide.

Founded in 1983