Cleveland Clinic
  • Independence, OH, United States
Responsibilities: Performs insurance prescreening and verification of benefits for multiple business lines within Connected Care (such as but not limited to: Home Infusion, Hospice, Nursing and Respiratory). Determines serviceability and makes recommendations based on patient’s insurance coverage which includes and not limited to: Identifying the need for and obtaining authorizations for service, calculating billable units for authorizations, understanding of the drug formularies, different therapies and the associated diagnoses with each and examination of referrals for adherence to the required/qualifying insurance regulations. Communicates directly with Pharmacy staff, Respiratory Therapy, Nursing Case Managers, patients and families to ensure understanding of approved benefit levels. Maintains customer relationships and ensures business objectives are met. Other duties as assigned. Education: High School Diploma / GED or equivalent required. Related college...
Cleveland Clinic Independence, OH, United States