Authorization Specialist
6 days ago
Minimum Requirements
Preferred Requirements
Education
High School Graduate/Diploma
Education
High School Graduate/Diploma
Experience
Minimum one year experience working with insurances and prior authorizations, preferred
Experience
Two – four years experience within a healthcare setting and familiarity with payor sources, processes and guidelines
Licensure, Certification, Registration
Licensure, Certification, Registration
Language Skills
Strong written and verbal English communication skills are necessary.
Language Skills
Strong written and verbal English communication skills are necessary.
Knowledge, Skills and Ability Requirements
• Experience and knowledge of insurances and prior authorizations
• Experience in Home Health and Hospice services and guidelines
• Knowledge of Government, Medicare Advantage and Commercial payors
• Experience with payor portals and clearinghouses
• Ability to effectively and professionally communicate with physicians, clinical and administrative staff, managers, patients and insurance companies
• Must be self-motivated and have the ability to work independently and within a team
• Excellent verbal and written communication skills
• Demonstrates excellent computer skills
•
Must demonstrate strong organizational skills
Start here at Hartford HealthCare and work where every moment matters Hartford HealthCare at Home doesn't just take great care of our patients; we take great care of our Registered Nurses too Our benefit options at Hartford HealthCare at Home are designed so you can care for yourself and your family, just as you care for others when you are here. Possibility of a sign‑on bonus based on eligibility.
Job Summary\: Under the direction of the Prebilling and Authorization Manager, the Authorization Specialist performs all duties related to insurance verifications and prior authorizations for Home Health and Hospice services in a timely manner. Maintains documentation and insurance portal access and ensures accurate records in the Electronic Medical Record (EMR)- Home Care Home Base (HCHB). Communicate updates in insurance or regulatory guidelines to the manager and relevant departments.
Key areas of responsibility:- Verifies insurance eligibility and prior authorizations accurately and timely for Home
Health and Hospice clients. Reviews daily workf lows, communicates updates to
leadership, ensures authorization details are entered for timely billing, and reports
coverage issues as needed. - Obtains prior authorizations f rom insurance companies by phone, fax, or portals;
submits required clinical documentation; accurately records authorization details in
HCHB; and communicates any changes in authorization or eligibility to regional
leadership. - Independently prioritizes work, keeps skills and knowledge current to serve as an
insurance resource, protects confidentiality, and communicates professionally with
payors, clients, and colleagues. - Ensures accurate account management and timely authorization requests per payor
guidelines, reports delays to the Manager, supports denial audits, and collaborates
with hospital departments on billing and authorization processes. - Assists with training of new prior authorization staff and other duties as assigned.
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