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Remote Authorization Associate
Posted 6 days agoViewed
💎 Seniority level: Entry, 1 year
🔍 Industry: Home Health Care
🏢 Company: BAYADA Home Health Care🫂 Last layoff about 3 years agoMedicalHealth Care
🗣️ Languages: English
⏳ Experience: 1 year
Requirements:
- Exemplifies characteristics of The BAYADA Way: compassion, excellence and reliability.
- Four (4) year college degree. (Preferred)
- Prior healthcare and/or home care experience preferred.
- One (1) year of relevant work experience obtaining authorizations and verifying eligibility is preferred.
- Demonstrated record of strong interpersonal skills and building relationships
- Self-motivated, flexible, and versatile.
- Strong customer service skills.
- Demonstrated record of goal achievement.
- Basic PC skills required to perform job functions.
- Proven ability to multitask and manage competing priorities.
- Ability to sort and arrange information and files in an appropriate manner.
- Acceptable pre-employment assessment results.
- Ability to read, write and effectively communicate in English.
Responsibilities:
- Demonstrate and communicate the core values of BAYADA and The BAYADA Way.
- Develop working knowledge of BAYADA’s mission, services, people, organization, policies and procedures.
- Provide backup support for routine support questions.
- Meet metrics that support BAYADA’s goals and objectives and measure effectiveness.
- Prepare reports and presentations using Microsoft Office (Word, Excel, PowerPoint etc.).
- Support annual audits and compliance reviews, as needed.
- Learn various aspects of the organization through technology training, hands-on learning, cross-training and site visits.
- Support authorization and eligibility workflow within appropriate system/s.
- Communicate effectively and maintain positive working relationships with insurance companies, referral sources, service offices, etc.
- Demonstrate solid performance or exceed performance standards in key job dimensions/attributes as defined on the Performance Appraisal for Office Staff.
- Perform related duties, or as required or requested by supervisor.
- Manage a caseload and provide customer support for dedicated service offices.
- Perform utilization management (review plan of care and utilization requests) to ensure proper number of days are requested.
- Respond timely to requests and/or escalate review of denied requests.
- Communicate with insurance companies via portals, phone or other third-party systems to request authorization.
- Support supplies and referral management.
- Provide any support to revenue cycle teams regarding authorization discrepancies or payor requirement changes.
- Submit appeals to insurance companies.
- Obtain denial letters from primary insurance companies when a secondary carrier is being billed yearly or as needed.
- Review and interpret authorization for services rendered to mitigate claim/EDI errors and denials
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