Residential Authorization and Insurance Specialist

2 days ago

Covington, Kentucky, United States Hire Velocity Full time
Job Summary

We are seeking a highly skilled Residential Authorization and Insurance Specialist to join our team at Hire Velocity. As a key member of our team, you will be responsible for ensuring seamless authorization and utilization processes for our residential services programs.

Key Responsibilities
  • Authorization and Utilization Process Management: Oversee the authorization and utilization process for our residential services programs, ensuring timely and accurate completion of documentation and verification of insurance coverage.
  • Insurance Information Management: Input and upload insurance information into our electronic health record system, verify insurance coverage and benefits, and coordinate primary and secondary benefits at admission and weekly.
  • Prior Authorization and Verification: Complete prior authorization required by insurance companies before patients can be admitted, and verify benefits to ensure coverage for daily operations.
  • Concurrent Review and Tracking: Track all concurrent reviews to ensure proper documentation is present to advocate for clients to receive the number of days at the highest level of care/most appropriate level of care.
  • Client Advocacy and Support: Provide feedback to the clinical team on each client's insurance case manager, documentation they want on the next review, and specific language/jargon that will help the client receive the level of care indicated.
  • Team Support and Collaboration: Provide backup support to the Director of Admissions for authorization and utilization reviews, and participate in agency Performance Quality Improvement and Quality Assurance Committee activities.
Requirements
  • Minimum of 2 years' experience as an authorization/utilization review specialist, within adolescent substance use and/or behavioral health facilities.
  • Familiarity with residential behavioral health services.
  • Experience with CareLogic electronic health record system preferred.
  • Strong verbal and written communication skills and ability to work effectively with insurance companies, their representatives, and case managers.
  • Alignment with the Sanctuary Institute's trauma-informed care model and the Human Rights Campaign's All Children All Families initiative in LGBTQ+ competencies.
  • Valid drivers' license or other ability to travel between sites in a timely manner required.
Benefits
  • Thirty-seven paid days off (13 paid holidays, 18 days of PTO, and 6 additional days of time off for illness of 3 or more days).
  • Four weeks of paid family leave (new child or care for a family member) after 1 year of employment.
  • Student Loan Repayment Assistance up to $10,000 over the course of employment.
  • Tuition Reimbursement of up to $5,000 per year.
  • Retirement Plan with 6% employer match.
  • Medical Plan with Zero Deductible and other benefits.

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