Authorizations Specialist

2 weeks ago

Brooklyn, United States True Care Full time

**Company Overview**:Empowering Health, Enriching Lives: True Care’s Enduring Mission

At True Care, we stand as a beacon of compassion and excellence in home healthcare. With a profound commitment to enhancing the quality of life for individuals and families, our mission is to provide holistic, personalized care that empowers health and enriches lives.

Every day, we embark on a journey to bring comfort, vitality, and dignity to those we serve. Our mission is driven by a deep understanding of the unique needs and aspirations of each individual under our care. We believe that home is not just a place but a sanctuary where healing and well-being flourish best. Hence, we endeavor to make this sanctuary a haven of health and happiness.

We pledge to create a nurturing environment where our clients and their families feel heard, valued, and supported. Our highly trained and empathetic professionals are not just caregivers but partners in the pursuit of well-rounded wellness. With a focus on open communication, collaboration, and respect, we forge lasting relationships that transcend the boundaries of traditional healthcare.

Our mission is to be a guiding light, illuminating the path toward optimal health and well-being. As we navigate challenges and triumphs together, we remain resolute in our dedication to uplifting lives, one compassionate interaction at a time.

At True Care, we don't just offer home healthcare - we offer hope, healing, and a brighter tomorrow.

**Position Title**: Authorizations Specialist

**Reports to**:Director of Finance

**Job summary**: The Authorizations Specialist handles all aspects of authorizations for patient services and is the liaison between the company and contracted partners. He/she is responsible for ensuring data received from our contracts is accurate, verified and then entered into the system. The Authorizations Specialist ensures continuity of service by acquiring authorizations as needed and confirming eligibility for active patients under all lines of business.

**Responsibilities include**:

- Responsible for reviewing insurance authorization forms for services provided to clients for corrections
- Monitor and track patient authorizations, informing supervisor of any expired dates
- Review and audit all authorizations for appropriate codes and units before entering into system
- Enter all confirmed authorizations into HHA eXchange and notify appropriate departments to continue with scheduling services
- Routinely verify insurance eligibility on contract websites and portals
- Routinely verify Medicaid eligibility on ePaces
- Follow processes and notify appropriate teams regarding lost eligibility or disenrolled members
- Run reports on upcoming expiring authorizations and follow processes to get increases for patient services
- Follow processes for paperless systems including eFax data tracking and scanning all documentation to centralized location
- Participate in data retrieval for claims appeals and requests for payment
- Liaison between the insurance companies and the agency
- Maintain appropriate logs or reports according to company standards
- Provide superior customer service through phone/fax management skills, computer documentation of codes and information for claims

**Job requirements**:

- High School Graduate/ GED equivalent
- Knowledgeable of basic office software technology; ePACES is a plus
- Experience in HHA eXchange is a plus
- Able to successfully work well in a team and also independently on certain projects and tasks

True Care provides equal employment opportunities to all employees and applicants for employment without regard to race, religion, color, ethnic origin, gender, gender identity, age, marital status, veteran status, sexual orientation, disability, or any other basis prohibited by applicable federal, state, or local law.

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