Insurance Verification Specialist - Contractor Only

Recora Health

Recora Health

Salt Lake City, UT, USA · United States · Austin, TX, USA · New York, USA · Remote
Posted on Jul 8, 2023

Mission

Empower everyone to live a long, full and optimal life by redefining the future of heart health.

1 in 3 humans die of heart disease - it's time to change that.

We're designing heart health from the ground up so that humans can live fuller lives. We're building technology to accelerate recovery after a cardiac event. And we're optimizing health stacks to realize preventive and aspirational goals.

Recora is redefining the future of heart health — we invite you to join us on this mission.

About Recora

Recora was founded in 2020 by seasoned digital health entrepreneurs. In past roles, we've founded and scaled high-growth startups, run large health systems, advised government programs, built technology you use every day, and provided healthcare for millions of lives.

We're backed by leading VCs including SignalFire, Pear, GFC , 2048, Great Oaks, MGV and more. Over the last year, we've built the leading virtual cardiac recovery and management platform for members with cardiac conditions. For every member we serve, we add an average of five years to their lifespan.

We're growing – fast. Our member base is doubling every month and we're looking to 3x our team size quickly. This will allow us to scale nationally and accelerate product development across the continuum of heart health.

Who We Are

We are innovators at heart. This driving force guides us to create, build, partner, and operate at the highest levels. We seek answers to some of the hardest problems in technology and healthcare and enjoy the process of finding unexplored solutions.

We're a group of diverse, thoughtful and humble folks. Having worked in organizations of every size and shape, we know that people make or break teams. An open, ego-free and supportive culture is central to making the best team of people at Recora.

As a team, we love our work and love working together. We take ownership in Recora and strive to grow personally and professionally in service of our mission. Because we enjoy hard problems and value growth, we can celebrate both challenges and excellence in equal measure.

What we're looking for

We’re working to deliver exercise and wellness for the older adult, initially focusing on cardiovascular disease. Our team consists of mission-driven clinicians, engineers, and scientists attacking this problem using evidence-based research and guidelines.

We are seeking an experienced care coordination and insurance verification professional to provide a delightful patient experience with clinical knowledge and passion for the heart health space. You will help provide recovery and preventative efforts by facilitating a thorough and meaningful beginning to their Recora journey.

Responsibilities

  • Anticipate patient challenges and effectively answer questions/gaps in understanding of insurance benefits
  • Educate patients and family members about Recora's program including the benefits of cardiac recovery and patient journey
  • Ensure timely follow-up response for patients that have insurance questions
  • Perform insurance verification of benefits and capture information in the patient records
  • Document insurance, provider, and clinical updates regarding patient health
  • Provide estimates for insurance eligibility including copays, coinsurance, or out of pocket costs
  • Thoroughly document correspondence with insurance, clients, and patients in the patient records
  • Calculate patient responsible balances based on coverage findings and documents in the patient records in Zendesk
  • Utilize online systems, phone communication, and other resources to verify eligibility and benefits, determine extent of coverage, and secure pre-authorizations before scheduling patients
  • Communicate insurance findings with relevant parties internally and externally
  • Maintain records and follow up for patients
  • Obtain patient responsibility, research payer coverage criteria and any required prior authorization requirements
  • Prepares and sends prior authorizations to insurance when required
  • Address incoming billing questions from patients and/or internal team members
  • Support other activities in the revenue cycle as needed

Your Past Experience

  • 1-2 years of call center operations, healthcare enrollment, sales experience (cardiology a plus), billing or collections
  • 1-3 years of care management/patient coordination experience in a clinical setting (cardiology a plus)
  • 3 years of insurance benefit verification experience
  • 2 years of Epic experience
  • 1-3 yrs of insurance portal experience, including NAVINET, AVAILITY, NORIDIAN, MyCGS, TRICARE, Etc.
  • Experience with CPT and ICD coding, preferred
  • Comfort with technology, including Google Suite and CRM software (Zendesk)

Other

  • Minimum of 30 hours a week. 40 hours a week, preferred
  • Strong knowledge of, and experience working withmedical insurance, including Medicare, Medicare Advantage plans, and other commercial insurance products
  • Multilingual a plus!
  • Hourly rate is $22

Note: This is a 1099 Contractor position only.