The Authorization Specialist is a position that performs the authorization requests for all insurances. This employee reports directly to the Authorization Manager, RCM.
Duties/Responsibilities:
Checking eligibility/benefits on patients as needed: Upon intake if not previously done for all patients and monthly on patients with non-Medicaid insurances and the beginning of each month where prior authorization is not required
At the beginning of every new year, obtaining details on eligibility, patients deductible and out of pocket costs
Communicating any patients that will have a patient responsibility with the appropriate staff so they can verify the patient will want services and to inform field staff to correctly fill out the consents
Tracking and obtaining all authorizations for all locations, along with reauthorization throughout duration of patient care
Data entering all authorization information into the system
Verifying accuracy in payor setup in EMR for all active policies
Maintain electronic record of all authorizations
Run reports daily, weekly, and monthly for department
Communicate with both internal and external customers to ensure authorizations are utilized accurately
Performs other duties as assigned
Required Skills/Abilities/Knowledge:
Excellent verbal and written communication skills with ability to communicate across all levels of field-based leadership
Demonstrates high degree of organization and problem solving
Able to effectively deal with change
Able to complete projects and tasks within specific timetables
Able to successfully interact with people in face-to-face situations as well as by telephone in a professional and effective manner
Requires the ability to communicate verbally and in writing and to maintain confidentiality of sensitive information
Requires the ability to use logical and scientific thinking to interpret technical data and solve a broad range of problems including the ability to use complex techniques to assess situations
Requires the ability to interpret, adapt and react calmly under stressful conditions
Must be able to relate cooperatively and constructively with clients and co-workers
Education/Experience/Licenses/Certifications:
High School Diploma or Equivalent
Medical, Dental, and Vision Insurance
Paid Time Off and Paid Sick Time
401(k)
Referral Program
Pay Range: $20 - $23 / hour
Team Select Home Care reserves the right to change the above job description and qualifications without notice. Team Select Home Care will not discriminate against you on the basis of race, color, religion, national origin, sex, sexual preference, disability, political belief, veteran status, age, or any other status protected by law. Team Select Home Care is an employment-at-will employer.