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Healthcare Authorization Coordinator

2 months ago

Wasilla, Alaska, United States Ancora Home Health & Hospice LLC Full time
Job Overview

Position Title: Authorization Specialist


Role Summary:

The Authorization Specialist plays a crucial role in managing essential clerical tasks and ensuring the seamless flow of documentation. Key responsibilities include handling phone inquiries, maintaining precise patient records for billing, overseeing inventory supplies, and executing various clerical tasks as required.

Location: Remote

Compensation: $17-$19 per hour

Qualifications:

To excel in this position, candidates must demonstrate proficiency in performing essential duties effectively. The following qualifications are indicative of the skills and abilities required:

  • Prior experience in authorization processes is preferred.

Licenses and Certifications:

  • Valid Driver's License and Auto Insurance
  • Completion of necessary competencies to validate and maintain skills

Analytical Skills:

  • Ability to identify and resolve issues, gather necessary data, and collaborate effectively with various departments and external entities to obtain critical information.
  • Strong multitasking abilities, exceptional organizational skills, and a keen attention to detail complemented by outstanding customer service capabilities.

Authorization Expertise:

Responsibilities include:

  • Verifying patient benefits and eligibility through online platforms and phone communications using appropriate billing codes.
  • Communicating coverage details and out-of-pocket expenses to intake staff.
  • Documenting prior authorization and precertification requirements.
  • Recording interactions with insurance representatives.
  • Initiating authorizations in Electronic Medical Records (EMR).
  • Submitting authorization requests along with necessary documentation to insurance providers using the correct forms.
  • Following up on pending authorizations and monitoring their status.
  • Updating EMR with the latest authorization information.
  • Uploading insurance documents into EMR.
  • Collaborating with the Billing Department.
  • Troubleshooting authorization and benefit-related issues.
  • Maintaining an updated tracking board.
  • Providing backup for incoming calls.
  • Offering support to clinicians as needed.
  • Assisting with general office tasks as required.

Technical Proficiency:

  • Familiarity with word processing, spreadsheet, database software, and Electronic Medical Records (EMR). Proficiency in Microsoft Office Suite (Access, Excel, Outlook, PowerPoint, and Word) is essential. Knowledge of Kinnser/WellSky is advantageous.

Physical Requirements:

  • Occasional (up to 33%): Standing, bending, kneeling, twisting, lifting up to 50 lbs., carrying up to 50 lbs., driving.
  • Frequent (34-66%): Walking.
  • Continuous: Sitting.

Education and Experience:

  • High School Diploma or equivalent.
  • 1 to 2 years of experience in Healthcare Administration, insurance verification/authorization, billing, or office administration. Experience in Home Health & Hospice is preferred.

Key Responsibilities:

  • Assist the Administrator, Director of Nursing, or Clinical Supervisor while maintaining confidentiality.
  • Perform general functions including sorting and distributing mail, managing incoming faxed documents, typing correspondence, compiling data, and assisting with special projects.
  • Maintain an organized office environment, including files, supplies, and overall office condition.
  • Answer phone calls and greet visitors professionally, addressing their immediate needs and directing them to the appropriate staff member.
  • Send physician orders for signatures as necessary, keeping a current log of submissions and tracking receipt of signed documents.
  • Plan, prioritize, and organize work to achieve established objectives.
  • Act as a responsible steward of agency resources, including managing equipment and necessary services.
  • Perform duties under the guidance of the agency's organizational structure.
  • Assist with various special projects and additional tasks as needed.
  • Adhere to agency policies and procedures, maintaining confidentiality of patient and agency information.
  • Participate in required in-service training and staff meetings.
  • Comply with Federal and State regulations and guidelines.
  • Uphold the agency's philosophy and core values.

Work Environment:

  • Primarily indoors in an office setting with occasional travel for office-related duties.

Supervision:

  • Reports to the Administrator, Director of Nursing, and Office Manager.

Risk Exposure:

  • Low risk.