Insurance Authorization Specialist - Clerical
HRS is now part of the AccentCare family, an ever-growing organization that is committed to quality care in our communities.
AccentCare is looking for passionate clinicians committed to delivering exceptional care in the home.
We are committed to quality patient outcomes—delivering evidence-based care in the home—and providing comprehensive training to further develop our staff along with continuing education and promotional opportunities.
Come join the AccentCare team and Make A Difference every day.
Position: Insurance Authorization Specialist
Reports to: Billing Analyst
As an Insurance Authorization Specialist, you will:
- Be responsible for oversight of the insurance authorization process. To include timely and complete processing of eligibility and benefit verification, initial and ongoing authorization requests and accurate entry of related information in designated software system.
- Maintain policies and procedures to ensure timely communication of verification and authorization status to field locations, providing necessary information to facilitate decision making for patient admission and visit utilization coverage. Communicates with management on areas of risk. Provide tracking and regular updates on outstanding issues.
- Maintain efficient tracking of all pending authorizations to ensure timely resolution and avoid loss of revenue.
- Perform routine review of outstanding requests and redirects workload as appropriate.
- Coordinate communication with the contracting department on payer related issues as appropriate.
- Ensure effective communication among team members; operations, finance, clinical, and support staff.
- Demonstrate ability to solve problems independently and perform at optimal level.
- Maintain confidentiality and privacy of patient/family finances, records, health status, etc.
Requirements of Qualified Candidates:
- High School Diploma Required; Bachelor’s Degree in Business, Accounting preferred
- Working knowledge of billing activities and Non-Medicare Home Health payor requirements
- Knowledge of Federal, State, and accreditation regulations governing home care
- Proficiency with MS Office Word, Excel and Outlook
- 1+ year previous experience with insurance verification, authorization or Billing experience