Operations Specialist - Billing/Authorizations

Position Overview
The Operations Specialist- Billing/Authorizations is responsible for providing top level customer service to internal and external clients as it relates to branch location’s clinical operational support activities.

Essential Job Functions
Billing/Authorization Activities:

• Verifies insurance benefits and coverage in a timely manner.
• Validates insurance information for accuracy and completeness.
• Submit TAR's and Authorization Request timely.
• Entering data in an accurate manner on a PRI Form.
• Follow-up and resolve denials and appeals.
• Follow through on out of the ordinary cases that require special handling.
• Assists in educating and acts as a resource for the branch offices.
• Consistently models the company's philosophy of customer service and compliance.
• Ability to understand Co-Insurances and Deductibles.
• Scanning and/or filing of documentation and records.
• Assist in answering of incoming calls and ensuring accurate messages are taken and given to the appropriate staff member.
• Mail distribution to appropriate staff member or department.
• Process invoices according to branch location guidelines
• Perform special projects as needed
  
  Requirements
  • High school diploma or GED
  • Proficient typing skills
  • Proficient Microsoft Office skills
  
  Preferences
  • Billing/authorization experience
  • Private duty, home care or health care company experience
  • Advanced Microsoft Excel skills
  • Two (2) years general office experience
  
  Other Skills/Abilities
  • Must maintain company and employee confidentiality at all times
  • Must maintain professional boundaries at all times
  • Ability to remain calm and professional in stressful situations
  • Attention to detail
  • Time Management
  • Effective problem-solving and conflict resolution
  • Excellent organization and communication skills
  
  Physical Requirements
  • Must be able to speak, write, read and understand English
  • Occasional lifting, caring, pushing and pulling of up to 25 pounds
  • Must be able to lift 50 pounds
  • Prolonged walking, standing, bending, kneeling, reaching, twisting
  • Must be able to sit and climb stairs
  • Must have visual and hearing acuity
  
  Environment
  • Performs duties in an office environment during agency operating hours
  • Must be able to function in a wide variety of environments which may involve exposure to allergens and other various conditions
  
  Other Duties
  • Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.