Patient Authorization Coordinator

2 weeks 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 within the organization. Key responsibilities include handling phone inquiries, maintaining precise patient records for billing, overseeing supply inventory, and performing various related clerical functions as required.

Work Location: Remote

Compensation: $17-$19 per hour

Qualifications:

To excel in this position, candidates must demonstrate the ability to fulfill each primary duty effectively. The qualifications outlined below represent the necessary knowledge, skills, and abilities, but are not exhaustive. Previous experience in authorization processes is preferred.

Licenses/Certifications Required:

  • Valid Driver's License and Auto Insurance
  • Completion of required competencies to validate and maintain proficiency

Analytical Skills:

  • Ability to identify and analyze issues, gather necessary data, and collaborate effectively with various departments, referral sources, facilities, and staff to obtain critical information and documentation.
  • Strong multitasking abilities, exceptional organizational skills, and a keen attention to detail, complemented by outstanding customer service capabilities.

Authorization Responsibilities:

Key tasks include verifying benefits and eligibility through online platforms and phone communications using appropriate billing codes:

  • Communicating benefit details and out-of-pocket expenses to intake
  • Documenting prior authorization and precertification requirements
  • Keeping records of interactions with insurance representatives
  • Initiating authorizations in Electronic Medical Records (EMR)
  • Submitting authorization requests with necessary documentation to insurance providers using designated forms
  • Following up on pending authorizations and monitoring their status
  • Updating EMR with authorization progress
  • Uploading insurance documentation to EMR
  • Liaising with the Billing Department
  • Addressing benefit and authorization challenges
  • Maintaining an updated tracking board
  • Providing backup for incoming calls
  • Supporting clinicians as required
  • Assisting with office tasks as needed

Technical Proficiency:

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

Physical Requirements:

  • Occasionally (up to 33%) - Standing, bending, kneeling, twisting, lifting up to 50 lbs., carrying up to 50 lbs., driving.
  • Frequently (34-66%) - Walking
  • Continuously - Sitting

Education and Experience:

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

Key Responsibilities:

  • Assisting the Administrator, Director of Nursing, or Clinical Supervisor while maintaining confidentiality. General functions may include sorting and distributing mail, managing incoming faxed documents, typing correspondence, compiling data, and assisting with special projects.
  • Keeping files, supplies, postage, and the general office environment organized.
  • Answering phone calls and welcoming visitors in a professional manner consistent with the organization's philosophy. Assisting callers and visitors by identifying their needs and directing them to the appropriate staff member.
  • Sending physician orders for signature as necessary and maintaining a current log of sent documents while tracking their receipt.
  • Planning, prioritizing, organizing, and completing tasks to meet established objectives.
  • Acting as a responsible steward of the organization's financial resources, including arranging for necessary equipment and services.
  • Performing duties under the guidance of the organization's organizational structure.
  • Assisting with various special projects and other duties as required.
  • Adhering to agency policies and procedures while maintaining confidentiality of patient and agency information.
  • Participating in in-service training and staff meetings as required.
  • Complying with Federal/State regulations, statutes, and laws.
  • Upholding the organization's Philosophy and Core Values.

Work Environment:

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

Reporting Relationships:

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

Risk Exposure:

  • Low risk

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