Authorization Associate

BAYADA Home Health Care•Parsippany, NJ

7d•Onsite

About The Position

The Associate, Authorization is a position responsible for ensuring that patient care services are ready to bill accurately and in a timely manner. The primary responsibility of the role is to obtain authorization for care from insurance carriers and provide denial support. This position will serve as a liaison between the service office providers, insurance carriers, and revenue cycle management functions. A high level of customer service and support is required to obtain insurance authorization and effectively communicate clients’ coverage.

Requirements

Exemplifies characteristics of The BAYADA Way: compassion, excellence and reliability.
Four (4) year college degree.
Basic PC skills required to perform job functions.
Proven ability to multitask and manage competing priorities.
Ability to sort and arrange information and files in an appropriate manner.

Nice To Haves

Prior healthcare and/or home care experience preferred.
One (1) year of relevant work experience obtaining authorizations and verifying eligibility is preferred.
Demonstrated record of strong interpersonal skills and building relationships
Self-motivated, flexible, and versatile.
Strong customer service skills.
Demonstrated record of goal achievement.

Responsibilities

Demonstrate and communicate the core values of BAYADA and The BAYADA Way.
Develop working knowledge of BAYADA’s mission, services, people, organization, policies and procedures.
Provide backup support for routine support questions.
Meet metrics that support BAYADA’s goals and objectives and measure effectiveness.
Prepare reports and presentations using Microsoft Office (Word, Excel, PowerPoint etc.).
Support annual audits and compliance reviews, as needed.
Learn various aspects of the organization through technology training, hands-on learning, cross-training and site visits.
Support authorization and eligibility workflow within appropriate system/s.
Communicate effectively and maintain positive working relationships with insurance companies, referral sources, service offices, etc.
Perform related duties, or as required or requested by supervisor.
Manage a caseload and provide customer support for dedicated service offices.
Perform utilization management (review plan of care and utilization requests) to ensure proper number of days are requested.
Respond timely to requests and/or escalate review of denied requests.
Communicate with insurance companies via portals, phone or other third-party systems to request authorization.
Support supplies and referral management.
Provide any support to revenue cycle teams regarding authorization discrepancies or payor requirement changes.
Submit appeals to insurance companies.
Obtain denial letters from primary insurance companies when a secondary carrier is being billed yearly or as needed.
Review and interpret authorization for services rendered to mitigate claim/EDI errors and denials.