Authorization Specialist - HomeCare

Hartford HealthCare•Farmington, CT

17d

About The Position

Work where every moment matters. Every day, almost 40,000 Hartford HealthCare colleagues come to work with one thing in common: Pride in what we do, knowing every moment matters here. We invite you to become part of Connecticut’s most comprehensive healthcare network as an Authorization Specialist. Hartford HealthCare at Home, the largest provider of homecare services in Connecticut, has been fulfilling our mission for more than 115 years. Our Person-Centered Care Model allows our employees to learn and grow within our organization, all while providing integrated support to the patient. As part of Hartford HealthCare, we leverage cutting edge technology to provide quality care in our client’s home. Most importantly, our employees are appreciated for the real differences they make in both the lives of their clients and their clients’ families. Under the direction of the Prebilling and Authorization Manager, the Authorization Specialist performs all duties related to insurance verifications and prior authorizations for Home Health and Hospice services in a timely manner. Maintains documentation and insurance portal access and ensures accurate records in the Electronic Medical Record (EMR)- Home Care Home Base (HCHB). Communicate updates in insurance or regulatory guidelines to the manager and relevant departments. Verifies insurance eligibility and prior authorizations accurately and timely for Home Health and Hospice clients. Reviews daily workflows, communicates updates to leadership, ensures authorization details are entered for timely billing, and reports coverage issues as needed. Obtains prior authorizations from insurance companies by phone, fax, or portals; submits required clinical documentation; accurately records authorization details in HCHB; and communicates any changes in authorization or eligibility to regional leadership. Independently prioritizes work, keeps skills and knowledge current to serve as an insurance resource, protects confidentiality, and communicates professionally with payors, clients, and colleagues. Ensures accurate account management and timely authorization requests per payor guidelines, reports delays to the Manager, supports denial audits, and collaborates with hospital departments on billing and authorization processes Assists with training of new prior authorization staff and other duties as assigned.

Requirements

Education: High School Graduate/Diploma required
Experience: Minimum one year experience working with insurances and prior authorizations, preferred.
Strong written and verbal English communication skills are necessary.
Experience and knowledge of insurances and prior authorizations
Knowledge of Government, Medicare Advantage and Commercial payors
Experience with payor portals and clearinghouses
Ability to effectively and professionally communicate with physicians, clinical and administrative staff , managers, patients and insurance companies
Must be self -motivated and have the ability to work independently and within a team
Excellent verbal and written communication skills
Demonstrates excellent computer skills
Must demonstrate strong organizational skills

Nice To Haves

Two – four years experience within a healthcare setting and familiarity with payor sources, processes and guidelines preferred.
Experience in Home Health and Hospice services and guidelines

Responsibilities

Performs all duties related to insurance verifications and prior authorizations for Home Health and Hospice services in a timely manner.
Maintains documentation and insurance portal access and ensures accurate records in the Electronic Medical Record (EMR)- Home Care Home Base (HCHB).
Communicate updates in insurance or regulatory guidelines to the manager and relevant departments.
Verifies insurance eligibility and prior authorizations accurately and timely for Home Health and Hospice clients.
Reviews daily workflows, communicates updates to leadership, ensures authorization details are entered for timely billing, and reports coverage issues as needed.
Obtains prior authorizations from insurance companies by phone, fax, or portals; submits required clinical documentation; accurately records authorization details in HCHB; and communicates any changes in authorization or eligibility to regional leadership.
Independently prioritizes work, keeps skills and knowledge current to serve as an insurance resource, protects confidentiality, and communicates professionally with payors, clients, and colleagues.
Ensures accurate account management and timely authorization requests per payor guidelines, reports delays to the Manager, supports denial audits, and collaborates with hospital departments on billing and authorization processes
Assists with training of new prior authorization staff and other duties as assigned.

Benefits

With locations around the state, Hartford HealthCare offers exciting opportunities for career development and growth.
Here, you are part of an organization on the cutting edge – helping to bring new technologies, breakthrough treatments and community education to countless men, women and children.
We know that a thriving organization starts with thriving colleagues-- we provide a competitive benefits program designed to ensure work/life balance.
Every moment matters. And this is your moment

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