Authorizations Specialist

True Care•New York, NY

11d•Onsite

About The Position

The Authorizations Specialist handles all aspects of authorizations for patient services and is the liaison between the company and contracted partners. He/she is responsible for ensuring data received from our contracts is accurate, verified and then entered into the system. The Authorizations Specialist ensures continuity of service by acquiring authorizations as needed and confirming eligibility for active patients under all lines of business.

Requirements

High School Graduate/ GED equivalent
Knowledgeable of basic office software technology; ePACES, and eligibility verification
Must be able to communicate professionally over the phone, in person and through email communication
Experience in HHAeXchange is required
Able to successfully work well in a team and also independently on certain projects and tasks

Nice To Haves

1-2 years of Homecare experience is a plus

Responsibilities

Responsible for reviewing insurance authorization forms for services provided to clients for corrections
Monitor and track patient authorizations, informing supervisor of any expired dates
Review and audit all authorizations for appropriate codes and units before entering into system
Enter all confirmed authorizations into HHAeXchange and notify appropriate departments to continue with scheduling services
Routinely verify insurance eligibility on contract websites and portals
Routinely verify Medicaid eligibility on ePACES
Follow processes and notify appropriate teams regarding lost eligibility or disenrolled members
Run reports on upcoming expiring authorizations and follow processes to get increases for patient services
Follow processes for paperless systems including E-fax data tracking and scanning all documentation to centralized location
Participate in data retrieval for claims appeals and requests for payment
Liaison between the insurance companies and the agency
Maintain appropriate logs or reports according to company standards
Provide superior customer service through phone/fax management skills, computer documentation of codes and information for claims