HME Authorization Specialist

Giving Home Health Care•Austin, TX

22h•Onsite

About The Position

Since 2012, Giving Home Health Care has been supporting individuals impacted by health conditions related to their work in nuclear facilities for the Department of Energy. With a focus on personalized, in-home care, we are committed to assisting those who have dedicated their careers to these vital roles. As a fast-growing, leading provider, we proudly serve patients across Arizona, Colorado, Kentucky, Missouri, Nevada, New Mexico, Tennessee, Texas, and Utah. If you’re a compassionate individual who puts patients first and thrives in a mission-driven, collaborative environment, we want you to join our team! Apply today and help us continue delivering exceptional care to those who need it most. The HME Specialist will serve as a critical member of the Giving Home Medical Equipment patient service team, specializing in the Prior Authorization Management. As part of the HME Operations Team which compiles, submits, and manages all Prior Authorization requests to the Dept of Labor.

Requirements

High school diploma or GED required
Minimum 3 years of experience in a DME business environment, healthcare administration, preferred.
Familiarity with DOL, DEEOIC, and private insurance billing processes is a plus.
Deep and instinctual understanding of Durable Medical Equipment and Home Medical Equipment. Its use, functions, and care.
Excellent communication and customer service skills.
Strong and kind phone presence.
Detail-oriented with strong organizational and time management abilities.
Brightree Experience.
Salesforce experience.
Strong time management skills.
Office-based, on-site role.
May require standing, sitting, or lifting equipment up to 50 pounds.
Must be able to work collaboratively in a fast-paced, compliance-focused healthcare environment.

Nice To Haves

Associate’s or Bachelor’s degree in a healthcare-related field preferred.

Responsibilities

Submit a high volume of complete and verified Authorization Packets working from multiple task and priority lists.
Manage Payor Portal Authorization updates and communicate these updates to team members.
Update Patient Records appropriately based on Authorization responses.
Update Salesforce and Brightree appropriately based on Authorization responses to direct actions to team members.
Complete tasks and Authorization requests promptly and within allowable timelines.
Scanning of mailed responses from Payors into Brightree and Salesforce systems and communicating responses to team members.
Place calls to DOL Medical Benefits Examiners to determine the reasoning behind Authorization processing decisions.
Receive calls from DOL Medical Benefits Examiners regarding questions for submitted Authorization Requests.
Communicate effectively and professionally with Payor representatives to ensure appropriate processing of Authorization Requests.
Communicate with patients/care team members/DOL via inbound and outbound phone calls.
Act as a liaison between patients, Home Health teams, clinicians, and payers to ensure seamless communication and service delivery.
Assist GivingHME as a whole by performing additional duties and responsibilities as necessary to provide the best care possible for patients.