LPN Insurance Liaison Assistant Nurse - Home Care (Full-Time Day Shift)

LPN Insurance Liaison Assistant Nurse - Home Care (Full-Time Day Shift)

Rochester Regional Health Home Care is the only home care provider in the region to earn a CMS 5-Star Quality of Patient Care rating, placing its CHHA among the top 3.5% of agencies nationwide. In addition, CHHA was recognized by U.S. News & World Report as a "High Performing Home Care Agency," further highlighting its commitment to exceptional patient care and clinical excellence.

The Insurance Liaison Assistant Nurse assists the Insurance Liaison staff in gathering data and information that our payers need in order to provide our agency with appropriate reimbursement. This assistant has direct contact with team members and other clinical and administrative staff or other internal departments, as well as external customers.

Attributes:

• Maintains knowledge of insurance and reimbursement guidelines and changes.
• Strong communication skills. Strong decision-making and problem-solving skills.
• Excellent time management and organizational skills.
• Ability to handle changing work environment and to prioritize activities.
• Proven ability to work in a team environment.
• Basic computer skills are necessary, including but not limited to the ability to navigate on a personal computer within a Windows based operating environment; the ability to access and create basic e-mail messages; and the ability to open, edit, and save basic electronic documents if necessary.
• With training provided, must demonstrate the ability to learn and utilize new systems, computer applications and operating environments as necessary.
• Flexibility to work a varied work schedule when needed to meet department needs.

Responsibilities:

• Prepares documentation as requested by the insurance liaison.
• Manages processes in the most efficient manner in an effort to streamline the team operation.
• Maintains all files in an organized manner.
• Receives and reviews communication from Professional Home Visiting Staff (nursing, PT, OT, ST, SW, etc.) regarding patients' needs, plan of care and interventions required for patient.
• Accurately documents approvals or denials using current software systems to communicate the information to appropriate internal staff.
• Responds knowledgeably and professionally to internal and external customers (providers, insurance agencies) inquiries regarding insurance coordination questions/issues.
• Appropriately and accurately inputs insurance authorization data and completes tasks with a focus on the patients' care needs and to assure timely authorization of services.
• Reviews referrals for those payers that require authorizations to ensure ongoing authorizations are obtained.
• Understands and utilizes Medicare home care guidelines in establishing home care referrals.
• Answers calls and obtains pertinent information to quickly and accurately identify and assess caller's needs and determine action steps to satisfy those needs or to resolve basic types of customer service inquiries.
• Collects, documents and provides reports of required data,
• Builds and maintains productive working relationships with all internal and external customers.
• Provides back up and support for all special assignments or tasks assigned to RN Insurance Coordinators and Manager.
• Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies' mission and values and adhering to the Corporate Code of Conduct.
• Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures.
• Regular and reliable attendance is expected and required.
• Performs other functions as assigned by management.

Preferred Qualifications:

• Minimum 5 years, home health care LPN experience preferred.
• Prior Insurance Coordination experience

Required Licensure / Certification & Skills:

• Graduate from an accredited School of Practical Nursing.
• Current LPN licensure in State of New York.

Education:

Licenses / Certifications:

Physical Requirements:

Sedentary - Sedentary roles are primarily office-based and require prolonged sitting (67100% of the workday) with minimal physical effort and lifting limited to under 10 lbs. Fine motor skills are necessary for computer work, writing, and telephone use, supported by clear visual and auditory ability. Cognitive and emotional demands are high due to extended concentration, frequent interruptions, independent decision-making, and information processing. Although physical exposure is low, administrative areas within healthcare environments may occasionally involve contact with infectious agents. Some roles may require flexible hours, TB screening, or a valid driver's license.

For disease specific care programs refer to the program specific requirements of the department for further specifications on experience and educational expectations, including continuing education requirements.

Any physical requirements reported by a prospective employee and/or employee's physician or delegate will be considered for accommodations.

Pay Range:

$23.00 - $31.00

City:

Rochester

Postal Code:

14607

The listed base pay range is a good faith representation of current potential base pay for a successful full time applicant. It may be modified in the future and eligible for additional pay components. Pay is determined by factors including experience, relevant qualifications, specialty, internal equity, location, and contracts.

Rochester Regional Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, sex (including pregnancy, childbirth, and related medical conditions), sexual orientation, gender identity or expression, national origin, age, disability, predisposing genetic characteristics, marital or familial status, military or veteran status, citizenship or immigration status, or any other characteristic protected by federal, state, or local law.