Authorization Specialist

Adara Home Health•Hutchinson, MN

3d•$42,000 - $53,000•Onsite

About The Position

The Authorization Specialist supports branch management by verifying initial and ongoing payer authorization and eligibility of home care services. The position reports to the Business Manager.

Requirements

Minimum of two years of experience in insurance authorization, billing, business administration.
Knowledge of third-party payer regulations including Medicare, Minnesota Medical Assistance, Veterans Affairs (VA), and private insurance.
Ability to promote and maintain a positive attitude and encourage others to do the same.
Strong organizational skills and the ability to work independently with minimal supervision.
Demonstrates ability to make appropriate judgments as it relates to the payer authorization process.
Strong written and oral communication skills.
Basic computer skills with the ability to learn new software.
Have U.S. Citizenship or evidence of valid Alien Work Permit.
Pass initial and ongoing background studies and screenings including but not limited to those of the Minnesota Department of Health and the Federal Office of the Inspector General’s List of Excluded Individuals and Entities.

Nice To Haves

Health care and home care experience preferred.
Knowledge of Word and Excel is a plus.

Responsibilities

Verifies insurance eligibility and authorization of current and potential home care clients in an accurate and timely manner.
Communicates payer authorization and eligibility information to Clinical Manager, Business Manager, or designee.
Enters insurance authorization and eligibility information into Company software.
Notifies branch management regarding lack of payer coverage or other service non-coverage issues.
Performs re-authorization and eligibility checks in a timely manner.
Communicates and documents information regarding change in authorization and eligibility to branch management.
Monitors and ensures all client authorization of services are current and quantity and type of services provided meet payer requirements.
Reviews and ensures appropriate processing of authorizations.
Sends informational correspondence to the payer.
Maintains professional, positive, and effective communication with payers, clients, Corporate and branch employees.
Maintains confidentiality of all information pertaining to clients, families, and employees.
Consults with branch management and clinical employees.
Performs other related duties and responsibilities as assigned.
Maintains knowledge and education to remain current, efficient, and productive as a home care insurance and payer resource to the branch.
Demonstrates self-direction to prioritize and accomplish job responsibilities.
Participates in the after-hours on-call process to assure client care policies and procedures are followed and staffing issues are resolved.