Authorization Specialist

New England Life Care-posted 2 months ago
Full-time • Entry Level
Scarborough, ME
251-500 employees
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New England Life Care (NELC) is one of the fastest growing home infusion therapy companies in New England and is the region’s only non-profit home infusion provider. NELC is a hospital collaborative serving more than 70 hospital systems in Maine, New Hampshire, and Massachusetts. NELC was created by local hospitals to ensure their patients have access to a provider that reflects their commitment to excellence in patient care, quality, and service. Like our owner hospitals, NELC provides patient focused care. New England Life Care has and continues to build a diverse, inclusive, and authentic workplace, so if you’re energized by this opportunity, but your experience doesn’t support every qualification in the job posting, we encourage you to apply! You still may be the person we are looking for! New England Life Care currently has a Remote Authorization Specialist position available. The normal schedule is Monday – Friday from 8:30am to 5:00pm.

  • Achieve performance appraisals with 'meets expectations' or better
  • Maintain a good record of attendance and punctuality
  • No Performance management deficiencies in the period
  • Demonstrate independence and competence to follow Authorization Request process for all payers
  • Demonstrate independence and competence to follow the Re-Authorization process
  • Demonstrate independence and competence to follow the Specialty process
  • Demonstrate independence and competence on all MOA's and therapies
  • Demonstrate independence and competence and ability to Authorize all services, document and communicate accurately on all changes of service, in CPR+ and to appropriate departments
  • Demonstrate independence and competence and ability to work through a TO DO without the need for extended timeframes
  • Demonstrates the ability to work within a team and independently with confident communication skills and exceptional customer service skills
  • Completes three continuing education programs in the period specifically related to professional development, LEAN and/or leadership development
  • High School Diploma, or equivalent required
  • Minimum of 2 years authorization, reimbursement or claims processing experience required
  • Practical experience with medical terminology; CPT, ICD-9 and HCPC coding preferred
  • Practical experience with Medicare, Medicaid and third-party payor contracts preferred
  • Knowledge of HIPAA Privacy and Security requirements preferred
  • Excellent organizational skills required
  • Basic accounting transaction/analyst skills required
  • Demonstrated ability to identify research and solve problems required
  • Ability to work independently as well as part of a team required
  • Practical experience with Microsoft computer systems and applications, to include Word & Excel
  • Remote position
  • Room for growth and potential for advancement
  • Health insurance
  • Dental insurance
  • Vision insurance
  • Generous employer-matched 403b savings program
  • Company paid: Life insurance, Short- and long-term disability insurance
  • Paid time off
  • And much more!
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