VERIFICATION SPECIALIST

Job Details
Job Location
C9990 - Sugar Land, TX
Remote Type
Fully Remote
Description
Healix Infusion Therapy, LLC is currently seeking a qualified remote full-time Verification Specialist to join our corporate business office and Verification Team. Currently, the position is a remote work arrangement and qualified candidates must have access to home internet and a dedicated work space free from distractions. Team members must have excellent communication skills and be able to professionally interact with patients, clients, and colleagues.
Schedule: Monday through Friday; 8:30am to 5:30pm CST
*Work hours are subject to change based on business needs and with supervisor approval.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
Include the following. Other duties may be assigned.

• Performs/reviews insurance benefit verification for ordered services.
• Obtains/reviews pre-certification, pre-determinations, and/or PCP referrals, as required by payor guidelines.
• Conducts Follow-up on pending intake items needed to approve ordered services.
• Completes financial analysis - enters allowable/fees, assesses client margin, and creates patient financial responsibility estimate based coverage and benefits.
• Notifies Supervisor of financial review outcomes/special pricing requests which fall below the minimums established by Healix policy.
• Issues systemic approval/denial for ordered services.
• Provides status communication/notification throughout the review process.
• May assist in advising patients of insurance benefits, estimated financial responsibility, and copay assistance enrollment processes (as applicable).
• Performs other related duties, as requested

CORE DUTIES AND RESPONSIBILITIES:
Include the following basic performance factors all Healix, Inc. employees are expected to meet.

• Communicates with clients and fellow employees through written and verbal forms, clearly and timely
• Interacts professionally with clients and fellow employees
• Cooperates with team members to accomplish departmental goals
• Accepts and incorporates changes or new ideas into daily work
• Provides service in a responsive, timely and accurate manner to both clients and fellow employees
• Understands and adheres to policies and procedures
• Arrives at work as scheduled and notifies supervisors in a timely manner of any absences
• Recognizes priorities and takes action; makes productive use of time
• Strives to resolve problems and conflicts on his/her own initiative
• Attempts to create new ideas or new procedures working as part of a group or individually.
• As a part of your job you will receive protected health information. It is your responsibility to comply with HIPAA in using and disclosing health information.

About Us
Healix is the nations leader in providing physician office-based infusion services. Focused on patient and physician peace of mind for 30 years, we offer unparalleled capabilities for optimal patient care, comfort, compliance, and clinical outcomes in an outpatient setting.
At Healix, we manage Office Infusion Centers on behalf of physicians, hospitals, and medical institutions, encouraging in-office treatment for optimal patient care. Our company is headquartered in Sugar Land, Texas, a suburb of Houston, where we have helped establish and manage hundreds of infusion centers nationwide. We use our clinical and business expertise to provide integrated solutions to improve all aspects of the infusion program, all while delivering peace of mind to our clients and their patients.
Studies show that the physician office infusion center setting provides significant site of care benefits for patients, communities, and payors, including superior clinical outcomes and lower cost of care. Overall patient satisfaction at Healix-managed infusion centers soars, with 98% of patients rating their care as excellent. Our physician clients rely on Healix to handle all facets of infusion center operations, including drug purchasing, revenue cycle management, managed care programs, and clinical staffing. As Healix continues to leverage unique industry expertise in management and service markets, we are dedicated to maintaining focus on patient and physician peace of mind.
Qualifications
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Education and Experience Required

• Bachelor's degree (B. A.) from four-year College or University, 2+ years of related experience and/or training; or equivalent combination of education and experience.

License and Certifications

• This job does not require any certificates, licenses, or registrations.

EQUAL EMPLOYMENT OPPORTUNITY
We are an Equal Employment Opportunity employer committed to providing equal opportunity in all of our employment practices, including selection, hiring, assignment, re-assignment, promotion, transfer, compensation, training, leave of absence, discipline, and termination. The Company prohibits discrimination, harassment, and retaliation in employment based on race; color; religion; national origin; sex; pregnancy, childbirth, or related medical conditions; age; disability or handicap; citizenship status; service member status; or any other category protected by federal, state, or local law. Healix has a non-discrimination policy and complies with applicable federal, state and local laws governing nondiscrimination in employment in every location in which the Company has facilities.