Pre-Authorization Specialist

Volunteers of America National Services (VOANS)•Montrose, CO

2d•$22 - $25•Onsite

About The Position

Join Home Health of Western Colorado as a Pre-Authorization Specialist in Montrose, CO. This is a paid opportunity to serve others, live our mission, and make a meaningful impact in a healthcare setting. Home Health of Western Colorado is a community of Volunteers of America National Services, a subsidiary of the Volunteers of America parent organization. Proudly Great Place to Work® Certified for 8 consecutive years. The Pre-Authorization Specialist plays a vital role in ensuring the efficiency and accuracy of our billing process. The Specialist will be responsible for the completion of the required authorization process by obtaining and verifying insurance coverage.

Requirements

1-2 years of relevant experience in medical bill and/or prior authorization within a health care practice.
High School Diploma required.
Experience with an Electronic Medical Record (EMR).

Nice To Haves

Bachelor’s degree in business, informatics or a clinical profession preferred; four (4) years of relevant experience can be substituted for bachelor’s degree.

Responsibilities

Streamline pre-certification, authorization and referral processes, ensuring compliance with insurance requirements.
Coordinates with insurance entities for effective communication and benefit determination.
Ensures timely and accurate insurance authorizations.
Request, obtain and verify authorizations for home health services from PARS insurance companies and managed care organizations.
Ensure all required documentation is submitted accurately and on time.
Tracks PARS and Authorizations and follows up promptly on pending or expiring authorizations.
Communicates authorization updates to clinical staff, schedulers, and billing personnel.
Reviews payer guidelines and stays updated on any changes related to coverage or authorization requirements.
Performs other duties as assigned.