Home Health Authorization Specialist

Trinity Health•Livonia, MI

1d•Remote

About The Position

As a Home Health Authorization Specialist, you will be responsible and accountable for the processing of all THAH authorization documentation meeting HCFA/MCC/JCAHO regulations and guidelines. Primary responsibilities include processing all frontend documentation needed to meet third party payer authorization deadlines assuring accurate billing. In addition, monitors all accounts for ongoing authorization needs to ensure optimal reimbursement and compliance per agency policy. This position works closely with the THAH insurance team and THAH Collection analysts in the tracking of authorizations and resolution of problematic billing issues. Monitors pending authorizations report and collaborates with both the clinical and revenue cycle team to review and resolve pending claims to ensure timely payment. Duties may be accomplished in a remote work environment.

Requirements

The incumbent can articulate and demonstrate a commitment to the mission, vision, and values of Trinity Health and to inspire active support of these in others.
A high school diploma or GED.
College business courses or an associate degree is preferred, or four to six years of experience in a medical billing office setting with a concentration on authorizations.
A strong knowledge of general business office functions, strong analytical and organizational skills and microcomputer usage is required.
Ability to meet strict deadlines with high level of accuracy.
Ability to prioritize multiple tasks in highly automated setting.
Possess strong interpersonal skills.
Ability to consistently demonstrate commitment to the mission and Organizational Code of Ethics and adhere to the Compliance.

Responsibilities

Prepare and enter data into the appropriate software assuring the accuracy of the regulated client account following all regulations placed on the homecare agency.
Timely follow up on pending authorizations to ensure payment of claims.
Generates all authorization documentation needed to bill in a timely manner assuring industry standards are met.
Monitors and processes the Subsequent Authorizations workflow and reports daily to assure timely and clean billing.
Provides statistical feedback regarding the status of unbilled claims due to authorizations to THAH Revenue team on a weekly basis or as defined by policy.
Interfaces with THAH to resolve problems related to the processing of bills/claims.
Investigates client accounts and provides any additional documentation required.
Seeks assistance of Clinical Team Leaders and/or Revenue Cycle Leaders with clinical data entry and/or billing problems.
Acts independently and responsibly to perform duties on a consistent basis and in a timely manner.
Acts as liaison between physician offices, THAH Service Center and the agency to assure timely billing with appropriate documentation.
Ensures that services provided support continuous quality improvement, customer-oriented focus, and quality client care outcomes.