Revenue Cycle Authorization Specialist

Compassus•Bay City, MI

About The Position

The Revenue Cycle Authorization Specialist models Compassus values of Compassion, Integrity, Excellence, Teamwork, and Innovation, promotes the Compassus philosophy and its 6 Pillars of Success, upholds the Code of Ethical Conduct, and supports positive working relationships across the company and with external stakeholders. The role primarily obtains authorizations for ordered healthcare services from payers that require authorization. The specialist reviews insurance verification, accurately enters information into software, and completes authorizations within established time frames. The role receives physician orders and coverage authorizations from agency designees, collaborates with agencies and the authorization team to meet timelines, and requests authorization from insurance case managers for specified services and care parameters. The specialist communicates effectively with patients, families, team members, and other healthcare professionals while maintaining confidentiality. Other duties may be assigned. Compassus describes a culture focused on compassion, respect, appreciation, career growth, professional development, innovation, recognition, and belonging. The company also states that it is an equal opportunity employer.

Requirements

High school diploma or GED required.
Ability to add, subtract, multiply, and divide using whole numbers, common fractions, and decimals, and to compute rates, ratios, and percentages.
Ability to read and interpret business and professional materials, technical procedures, and governmental regulations; write reports, business correspondence, and procedure manuals; and present information and respond to questions.
Strong written and verbal communication skills.
Ability to understand, read, write, and speak English.
Basic computer knowledge and experience working in a computerized automated environment.
Knowledge of Microsoft Word and Excel required.
Ability to use independent and critical thinking to achieve assigned objectives.
Ability to organize and prioritize, demonstrate attention to detail, work accurately and promptly, make sound decisions, and maintain confidential information.
Ability to articulate and embrace hospice philosophy.

Nice To Haves

One or more years of insurance authorization experience preferred.
Prior experience in home health, hospice, palliative care, or infusion preferred.
Utilization management experience and pre-certification helpful.
Customer service experience desired.

Responsibilities

Obtain authorizations in a timely manner.
Review insurance verification and complete the authorization process within established time frames.
Accurately enter data into the software program.
Receive physician orders and coverage authorization from an agency designee and work with the agency to meet established timelines.
Work closely with and support team efforts to accomplish authorization and verification.
Request authorization from insurance company case managers for specific services and parameters of care.
Communicate effectively with patients, families, team members, and other healthcare professionals while maintaining confidentiality.
Perform other duties as assigned.