Authorization Specialist I, RCM

Team Select Home Care•Denver, CO

3d•$18 - $21

About The Position

The Authorization Specialist performs authorization requests for all insurances and reports directly to the Authorization Manager, RCM. The role supports authorization and eligibility workflows, maintains authorization records and system data, and communicates with internal and external customers to ensure authorizations are used accurately.

Requirements

High school diploma or equivalent.
Excellent verbal and written communication skills, including the ability to communicate across all levels of field-based leadership.
Strong organization and problem-solving skills.
Ability to deal effectively with change.
Ability to complete projects and tasks within specified timeframes.
Ability to interact professionally and effectively with people face-to-face and by telephone.
Ability to communicate verbally and in writing and maintain confidentiality of sensitive information.
Ability to use logical and scientific thinking to interpret technical data and solve a broad range of problems, including using complex techniques to assess situations.
Ability to interpret, adapt, and react calmly under stressful conditions.
Ability to relate cooperatively and constructively with clients and coworkers.
Ability to write, dictate, or use a keyboard to communicate directives.
Ability to use proper body mechanics in multiple environments and function in multiple environments.

Responsibilities

Check patient eligibility and benefits as needed: upon intake if not previously completed, monthly for patients with non-Medicaid insurance, and at the beginning of each month when prior authorization is not required.
At the beginning of each year, obtain details about eligibility, patient deductibles, and out-of-pocket costs.
Communicate patient responsibility information to appropriate staff so they can confirm patients want services and inform field staff to complete consents correctly.
Track and obtain authorizations for all locations, including reauthorizations throughout the duration of patient care.
Enter authorization information into the system.
Verify the accuracy of payor setup in the EMR for all active policies.
Maintain electronic records of all authorizations.
Run daily, weekly, and monthly department reports.
Communicate with internal and external customers to ensure authorizations are utilized accurately.
Perform other duties as assigned.