Authorization Specialist (Home Health)

Position: Authorization Specialist

Supervisor: Home Health Agency Administrator

Employment Status: Full-time

FLSA Status: Non-Exempt

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Summary:

Primary function is to obtain authorization for home health services for all services ordered for all payers (Medicare replacement, Medicaid and commercial plans) that require an authorization.

Essential Duties and Responsibilities:

 Obtains authorizations in a timely manner

 Reviews the insurance verification and completes the authorization process within established time frames. Accurately enters data into software program

 Receives MD order and coverage authorization from agency designee.

 Works closely with agency to meet established timelines

 Works closely with and supports team efforts to accomplish authorization/verification

 Requests authorization from insurance company Case Managers to provide specific services and parameters of care

 Provides effective communication to patient/family, team members, and other health care professionals and maintains confidentiality

 Adheres to all company policies and procedures.

 Provides supportive services to other office staff, such as scheduling, intake and answering phones

 Performs other duties as assigned.

Minimum Qualifications:

Education/Licensing/Certification:

 High School Graduate or equivalency.

Experience:

 One or more years of insurance authorization experience preferred.

 Experience in the health care billing industry, preferred.

 Utilization management experience and pre-certification helpful.

 Customer Service experience preferred.

Knowledge and Skills:

 Knowledge of insurance policies for home care authorizations

 Ability to establish and maintain effective working relationships with all segments of the branch staff, billing and collections department and, insurance representatives

 Self-Starter and able to work independently

 Ability to multi-task

 Usage of Medical Terminology

 Strong negotiation and conflict management skills

 Computer literate and can learn new software programs

 Can use basic office equipment including but not limited to desktop computers, printers, fax machines, telephones.

Training:

 Will receive orientation and pre-service training on operations of Aging True.

 Will attend pertinent in-service training’s as schedule permits.

Anyone with these skills that is interested in this position please email your resume to homehealthjobs@agingtrue.org with the subject line “Authorization Specialist Aug 2019

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AGING TRUE IS AN EQUAL OPPORTUNITY EMPLOYER

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