Authorization Specialist – Per Diem
Weekends and Holidays – Hourly, Non-Exempt.
Remote work is a possibility.
Performs weekend and holiday authorization tasks in support of the Revenue Cycle Department. Works under the direction of the Revenue Cycle Manager.
Standard I – FUNCTIONS:
- Prepares, submits, and verifies authorization for admissions. Reviews & follows up with scheduling and clinicians on point of care (POC) for more insurance authorization requests or discharge from service requests.
- Calls/Faxes authorization requests following third party payor protocols. Tracks authorization requests and enters them into the Home Care Home Base system when obtained.
- Performs verification of insurance on admission and enters them into the Home Care Home Base system.
- Communicates with Schedulers/Supervisors/Intake as to authorizations pending and those obtained.
- Verification of new Resumption of Care patients and Medicaid patients.
- Reviews Home Care Home Base reports for issues requiring attention e.g., unable to schedule visits due to outstanding authorization, new admissions, etc.
- Follows policies and procedures of VNHH.
- Participates in mandatory in-services and educational programs required for VNHH staff.
- Adheres to HIPAA regulations and maintains confidentiality of all information.
Standard II – EDUCATION AND EXPERIENCE:
- High school diploma or equivalency.
- Medical Office experience preferred.
- Knowledge of medical terminology.
Standard III – QUALIFICATIONS:
- Computer literate; pleasant telephone manner.
- Knowledge of third-party insurance.
- Ability to problem solve and multitask.
- Requires excellent attention to detail and communication skills.
- Ability to use technologies including electronic medical record software, Microsoft Word Excel, and Outlook, telephone, fax machine, and copier/scanner.
- Ability to work as a team member and to function independently.
It is the policy of Visiting Nurse Home & Hospice to provide equal employment opportunities without regard to race, color, religion, sex, national origin, age, disability, marital status, veteran status, sexual orientation, genetic information or any other protected characteristic under applicable law.
Please submit applications in writing to Dawn Pagliaro in Human Resources
via email to: firstname.lastname@example.org or via fax to 401-682-7562.