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Authorization and Intake Specialist
4 months ago
Job Summary:
The Authorization and Intake Specialist is responsible for the coordination of efforts with outsourced authorization and eligibility contractors to obtain authorization from insurers to invoice for the Home Health and Hospice service lines. Ensures tasks and procedures required to obtain insurance authorizations in these service lines are performed in an accurate and timely manner. Evaluates processes and procedures and assists the Intake and Medical Records Manager in developing revisions when necessary. This is a part time .6 FTE with benefit options available.
Essential Duties and Responsibilities:
1. Coordinates the tasks of various staff to obtain required insurance authorizations required to invoice payors.
2. Works with the third-party authorization company to obtain appropriate authorizations in a timely manner.
3. Obtains and updates VA authorization to ensure care without interruption.
4. Verifies insurance authorization and payment changes have been processed appropriately.
5. Verifies Medicare eligibility to ensure timely onboarding of new admissions and coordinates outsourcing of this when appropriate.
6. Updates intake demographic information as necessary.
7. Informs appropriate staff of authorization/referral requirements and maintains open communication between third party authorization company and on-site intake and operations teams.
8. Processes clinical data including but not limited to computer entry of referral data, medication information, and faxed orders for home health and hospice services.
9. Receives, responds to, and follows up on phone calls within the position’s scope of responsibility.
10. Performs miscellaneous office work including but not limited to faxing, copying, and routing of clinical and clerical information.
11. Performs other duties as assigned by supervisor.
12. This is an in office role at our Missoula, MT location.
Minimum Qualifications:
High school diploma required (college degree in related field preferred). General proficiency with computer software and Microsoft suite required, including accurate data entry and attention to detail. Experience with medical terminology required. Previous CNA, Medical Assistant, or knowledge of Medicare and Medicaid reimbursement requirements strongly preferred. Experience in the field of Medical insurance and authorization strongly preferred.
Personal Qualities:
Skilled in communicating with referral sources, physicians’ offices, medical facilities, etc. to obtain the necessary insurance information to fulfill job responsibilities. Organized, collaborates with co-workers well, and tenacious is pursuing documentation required.
