Authorization Specialist

Duties and Responsibilities

• Performs communication to obtain authorization of home health services.
• Interfaces with providers/office staff/clinical staff/caregivers for the purpose of attaining additional information required for authorization approval.
• Provides direct support regarding utilization, authorization, and referral activities.
• Updates patient demographics and insurance as needed.
• Assists in gathering information needed for coordinators, case managers, and clinical staff to determine continued authorization.
• Tracks frequency of visits on all visits for PDN and/or therapy patients.
• Contacts providers and families with authorization, denial, and appeals process information.
• Verifies eligibility of members and members benefit coverage.
• Assists with the identification and reporting of quality management and non-coverage issues.
• Responsible that all discrepancies are reported to the Director of Clinical Services, Director of Therapy, and Account Manager
• Cross Trained with Intake Specialist.
• Insurance knowledge experience AHCCCS(Arizona Medicaid), Aetna, BCBS, Cigna/CareCentrix, TriCare, United Health Care, etc.
• Performs all other duties assigned by Director of Clinical Services, Director of Therapy, and Account Manager.
• Supports and executes the mission, ethics, and goals of the company effectively.

Requirements / Preferences

• High School Education - *Associates Degree preferred
• Exceptional Customer Service
• Must be detailed oriented
• Familiarity with ICD-10 coding
• Able to work independently
• Ability to perform basic to intermediate applications with Excel
• Strong verbal and written communication skills (Additional languages preferred)
• 1 year experience in a clinical environment preferred
• Requires in depth knowledge of benefits and authorizations
• Proficient use of standard computer programs for data entry and data organization

This is a full-time position that offers a starting hourly pay rate of $17-$23 per hour.

• Competitive wages
• Weekly pay
• Medical, Dental & Vision Coverage – Available 1st of the month following 30 days of employment
• Health Savings Accounts (HSA)
• Flexible Spending Accounts (FSA)
• Voluntary Short Term & Long Term Disability
• Employee Assistance Program (EAP)
• 401(k) retirement plan
• Paid Time Off (PTO)
• 7 Company Paid Holidays
• 100% Company Paid Life Insurance
• Voluntary Life Insurance
• Accident, Hospital, and Critical Illness Insurance
• Identity Theft Protection Plan
• Discounted Legal Care Plan

All your information will be kept confidential according to EEO guidelines.