Home Health Authorization Specialist
Company: Stonerise Corporate
Location: Charleston
Posted on: May 27, 2023
Job Description:
Stonerise Corporate - Stonerise Home Health and
HospiceAuthorization and Verification SpecialistPOSITION
SUMMARY:The Authorization and Verification Specialist will work in
combination with Intake and Agency teammates and any external
authorization and verification vendors to ensure our processes and
workflows are executed successfully, set goals and best practices
are achieved, and the risk of lost revenue is minimized. In this
role, you will be driving both internal and external customer
satisfaction through a focus on faster and more efficient
reimbursement. The ideal candidate will not only ensure a positive
experience for patients, providers, and fellow teammates, but will
also be a key contributor in optimizing and standardizing
authorization and verification workflows.CORE RESPONSIBILITIES:
- Submit authorization requests timely, following payer specific
guidelines
- Partner with front desk teammates within clinics to ensure
appropriate and accurate documentation for authorization submission
is completed and uploaded for submission
- Provide regular regarding areas of opportunity in authorization
or verification timeline or process
- Address and respond to authorization or verification related
queries
- Ensure all authorization and verification related denials are
addressed timely and accurately, providing denial prevention
feedback to Intake and Agencies as needed
- Accurately and timely complete verifications by contacting the
provided insurance via phone, fax, or online portal to obtain
benefits, eligibility, and authorization information
- Request, follow-up, and secure authorizations communicating
appropriately with Agency teammates to ensure timely patient
care
- Complete Monthly eligibility verification and partner with
Agency teammates to ensure follow-up is completed for ineligible
results. Open new chart when a change is to an in-network
carrier
- Assist with training and education of new teammates as well as
ongoing training and education for established team members
- Maintain a professional and collaborative relationship with all
teammates and vendors to resolve issues, increase knowledge of
insurance requirements, and create standardized workflows
- Perform other duties as assigned by leadership
staffQUALIFICATIONS & SKILLS: -
- Experience Home Health Intake and or Insurance
Verification
- Demonstrates flexibility in responding to priorities and
organizational change
- Demonstrates ability to work under pressure and follow through
on assignments
- 2-3 years previous experience in pre-auth verification;
experience with obtaining authorizations, referral coordination,
and patient services preferred
- Ability to multi-task, prioritize needs to meet required
timelines
- Customer service experience
- Effective written and verbal communication skills
- Solution oriented mindset and ability to use critical thinking
and analytical skills
Keywords: Stonerise Corporate, Charleston , Home Health Authorization Specialist, Healthcare , Charleston, West Virginia
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