Health Care Compliance Specialist II

We are hiring a Health Care Compliance Specialist I for one of our clients in Paramus NJ.

Job Description:

• Assist with the Admission Process of residents.
• Assist in the determination of income financial obligation and eligibility of care (including health insurance).
• Review and provide verification of health insurance status and eligibility of coverage of potential and existing residents.
• Conduct a monthly audit of health insurance eligibility of existing residents in Ability or other healthcare insurance eligibility application.
• Answer family members POAs potential residents calls emails and questions regarding the Admission Process (including health insurance eligibility and coverage).
• Assist in sending communications and status of the Admission Process (including health insurance) to family members POAs and potential residents.
• Assist in filing and maintaining health insurance information of potential current and deceased residents.
• Assist family members POAs potential residents in changing and updating health insurance coverage that best meet the needs of the resident.
• Maintain and submit memos to other nursing home units (Nursing Social Service Pharmacy and Business Office) regarding health insurance coverage of admitted and current residents.
• Manage resident accounts with contact information insurance and financial information in a confidential manner.
• Schedule potential residents admission date to the nursing home.
• Assist family members POAs potential residents in completing paperwork for the Admission Process.
• Educate family members POAs potential residents about their health insurance options and the Admissions Process of the nursing home.
• Ability to discuss or answer the basic financial obligation questions which include but not limited to the following with the family members POAs and potential residents:
• Cost of Service
• Insurance Eligibility and Coverage
• Payment Options
• Refer to Residents Account Office when necessary.
• Scan applicable documents into residents chart(s) or file(s) as necessary.
• Ensure compliance with professional standards & regulatory requirements.
• Keep up to date with the latest trends in health care by attending seminars and sharing this information with the team.

Skills Required:

• Pleasant personality; Interactive; Inclusive
• Computer operations; Ms. Office; Phone operations; Customer Service
• MS Office and Outlook

Experience Required:

• Experience with Computer and phone operations Health Insurance.

Work Hours:

• 8 AM 4:30 PM
• Lunch hours(unpaid): 30 min Break

Additional Information:

• Work from office or remote: office
• Parking Yes
• Dress Code Casual Formal

About Us:

We are specialized in recruiting and deliver the best professional talent of industry and we are committed to deliver best experience for our clients and job seekers. With over two decades of experience in the recruitment industry we proudly help you to find the next job that matches your professional skills. Our team understands your needs or requirement before starting the recruitment that enables to find the high quality of talent with high success rate of talent delivery keeps us continue to be the best in the industry.