The Authorization Specialist II, RCM is a position that performs the authorization requests for all insurances. In this role, you will report to the Authorization Manager, RCM.
Duties/Responsibilities:
Checking eligibility/benefits on patients as needed: Upon intake if not previously done for all patients, monthly on patients with non-Medicaid insurances, and at the beginning of each month where prior authorization is not required
At the beginning of every new year, obtaining details on eligibility, patients deductible and out of pocket costs
Communicating any patients that will have a patient responsibility with the appropriate staff so they can verify the patient will want services and to inform field staff to correctly fill out the consents
Tracking and obtaining all authorizations for all locations, along with reauthorization throughout duration of patient care
Data entering all authorization information into the system
Verifying accuracy in payor setup in EMR for all active policies
Maintain electronic record of all authorizations
Run reports daily, weekly, and monthly for department
Communicate with both internal and external customers to ensure authorizations are utilized accurately
Determine through eligibility and payer knowledge if the company can service a patient
Appeal denials as required by payer, including appeals through the health commission or applicable governing body
Attend regular meetings with branches as needed to ensure open communication
Perform other duties as assigned
Required Skills/Abilities/Knowledge:
Excellent verbal and written communication skills with ability to communicate across all levels of authority within company
Excellent organization, problem solving, and project management skills
Able to independently file appeals with multiple payors
Troubleshoot eligibility issues with internal teams as it relates to insurance coverage
Able to effectively deal with change
Understand the patients benefits throughout the patient admission
Able to complete projects within specific timetables
Able to successfully interact with people in face-to-face situations as well as by telephone in a professional and effective manner
Education/Experience/Licenses/Certifications:
Benefits + Perks of Joining the Team Select Family
Medical, Dental, and Vision Insurance
Paid Time Off and Paid Sick Time
401(k)
Referral Program
Pay Range: $16 - $21 / hour
Team Select Home Care reserves the right to change the above job description and qualifications without notice. Team Select Home Care will not discriminate against you on the basis of race, color, religion, national origin, sex, sexual preference, disability, political belief, veteran status, age, or any other status protected by law. Team Select Home Care is an employment-at-will employer.