Authorization Specialist

4 weeks ago

Cortez, United States Pasco Southwest Home Health Full time
Job Summary

The Authorization Coordinator plays a crucial role in ensuring smooth clinical operations by obtaining referral or prior authorizations for Home Health and Hospice services. This position requires strong communication and coordination skills to work with patients, families, and physician offices.

Key Responsibilities
  1. Maintain positive relationships with healthcare providers and community contacts.
  2. Process authorization and referral requests in a timely and accurate manner.
  3. Provide support to case management staff and serve as a resource for providers.
  4. Build and maintain strong relationships with referral sources and other community contacts.
  5. Work with the office team to provide other types of office support as needed.
  6. Verify member eligibility and benefits.
  7. Provide referral authorization to external providers according to established policies and procedures.
  8. Request submission of medical records according to established criteria.
  9. Issue authorization within the appropriate time frame for routine, urgent, and emergent requests.
  10. Forward referral requests to the next level of review.
  11. Distribute correspondence and other information to the appropriate parties or departments.
  12. Maintain logs, records, and reports as established in the Utilization Department.
Requirements
  1. 2-5 years of experience in a related field.
  2. Strong written and oral communication skills.
  3. Excellent customer service skills.
  4. Strong team skills.
  5. Organized and flexible.

Pasco Southwest Home Health is a leading provider of home health and hospice services. We are seeking a highly skilled and motivated Authorization Coordinator to join our team.

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