Authorization Specialist

4 weeks ago


Albany, United States Marquis Home Care Full time

Marquis Home Care -

The Authorization Specialist will receive confidential patient information and insurance information for the purpose of processing referrals for the Certified Home Health Agency (CHHA), the Licensed Home Care Agency (LHCSA). This position will track and coordinate authorization numbers and timeframes necessary to continue service provision for the homecare division.

Qualifications:

Minimum one (1) year experience in a health care facility or insurance company

Computer experience in Microsoft Office based products and simple spreadsheets

Demonstrated excellence in customer service

Understanding of Home care and Medicare/Medicaid fee sourcing preferred

JOB RESPONSIBILITIES

Professionally interact with insurance sources and effectively demonstrate excellence in customer service for both internal and external customers.

Performs workflow and documentation within the electronic medical record and reports deviations in workflow to the Manager.

Observes patient’s rights and confidentiality while obtaining needed information to complete referral and authorization process.

Accurately reports and records authorization numbers and date/time frames contact information and insurance information on the intake referral form within the medical record.

Suggests process/form changes to enhance efficiencies within the department.

Assists the Central Intake and Scheduling Manager and AED/Director of Patient Services as requested.

Participates in case conference, in-service, and other programs, committees and meetings as needed.

Ensures that all authorization information is obtained prior to service delivery and communicates any concerns or issues directly to the Central Intake and Scheduling Manager and Clinical Managers.

Participates in Quality Improvement activities as directed.



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