Authorization SpecialistJob Summary

The Authorization Specialist is responsible for several routine clerical duties and assuring that documents flow in a coordinated and efficient manner. Primary responsibilities are answering phones, maintaining accurate patient records for billing purposes, monitoring supply inventory and other related clerical duties as assigned.

Location:

Wasilla, AK

Pay Rate

$17-$19 an hour

Qualifications

:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required, but is not all inclusive. Prior authorization experience preferred.

Licenses/Certifications

Valid Driver's License and Auto Insurance

Must complete required competencies to validate and maintain competency

Reasoning Ability

Ability to identify and define problems, collect data as needed, work well with other Ancora branches, referral sources, facilities, direct reports and other staff as needed to obtain essential information and documentation.

Ability to multitask, highly organized and detail oriented with excellent customer service skills.

Authorization Skills

Verifying benefits and eligibility (online and by phone) using correct billing codes

Communicating benefits and out-of-pocket costs to intake

Documenting prior authorization/precertification requirements

Documenting communication with insurance representatives

Opening authorization in EMR

Submitting authorization requests with supporting documentation to insurance companies using the appropriate forms

Following up on pending authorizations and tracking authorization status

Updating EMR with authorization status

Uploading insurance documents to EMR

Communicating with Billing Department

Troubleshooting benefit/authorization issues

Keeping tracking board updated

Backup for incoming phone calls

Clinician support as needed

Office support as needed

Computer Skills

Knowledge of Word processing software, Spreadsheet software, Database software and Electronic Medical Records (EMR). Must be proficient in the use of a PC, web-based portals and Microsoft Office Suite (Access, Excel, Outlook, PowerPoint and Word). Knowledge of Kinnser/WellSky is a plus.

Physical Demands

Occasionally (up to 33%) - Standing, Bending, Kneeling, Twisting, Lifting up to 50 lbs., Carrying up to 50 lbs., Driving.

Frequently (34-66%) - Walking

Continuously (67-100%) - Sitting

Education/Experience

High School Diploma or Equivalent

1 to 2 years' experience in Healthcare Administration or medical field, insurance verification/authorization, billing or office administration. Home Health & Hospice experience preferred.

Responsibilities

Provides assistance to the Administrator, Director of Nursing or Clinical Supervisor, preserving confidential nature of which he/she has knowledge. Performs general functions which may include the following: sorting and distributing mail, distribution of incoming faxed documentation, typing documents and letters, assembling date, copy materials, assisting in the performance of special projects, or faxing information to physicians or outside agencies.

Maintains the files, supplies, postage and general office condition in an orderly manner.

Answers telephone and greets visitors in professional manner consistent with Agency philosophy. Assist callers and visitors by identifying their immediate needs and referring them to an appropriate staff member.

As necessary, sends physicians orders for signature. Keeps current log of what is sent and tracks receipt of signed document.

Plan, prioritize, organize and complete work to meet established objectives.

Should be a good steward of all agency financial resources, including but not limited to arrangements for equipment and other necessary items and services needed.

Performs duties in accordance of and under the direction/supervision as defined by the Agency's organizational chart.

Assists on a variety of special projects and other duties as needed.

Follows agency policies and procedures. Maintains confidentiality of patients and agency information.

Attends in-service and staff meetings as required.

Adheres to Federal/State guidelines rules regulations, statues and law.

Follows Agency's Philosophy and Core Values.

Working Environment

Works indoors in Agency office and occasional travel for office duties.

Job Relationships

Supervised by Administrator, Director of Nursing and Office Manager.

Risk Exposure

Low risk

Ancora Home Health and Hospice

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Authorization Specialist