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Home Health Authorization Specialist (Hybrid work)

Apply Job ID HOMEH009186 Date posted 09/16/2024 Position Type Full-Time

Join our dynamic team as a Home Health Authorization Specialist with Empath Health, where you’ll have the flexibility to work both remotely and, in our Brandon, FL office. This hybrid work model allows you to balance productivity and collaboration while enjoying the convenience of working from home.

Assumes day-to-day responsibility processing insurance authorizations and assists on daily insurance benefits coverage verifications for patient admissions in conformance with agency policies and procedures.

JOB DUTIES/RESPONSIBILITIES:

  1. Demonstrate professional conduct and ethics according to agency policy and procedure.
  2. Maintain confidentiality of patient information and all Agency operations.
  3. Provide assistance processing all incoming patient insurance benefits coverage verification referrals from physicians and acute/non-acute facilities.
  4. Screen insurance benefits coverage verification referrals for admission to home health services based on agency policies and procedures.
  5. Verify Medicare benefit eligibility through on-line Direct Data Entry (DDE) checks; and if necessary, confirm beneficiary’s status with other agencies by phone.
  6. Coordinate completion of prior authorization and re-authorizations with insurance companies.
  7. Troubleshoot authorization related issues and follow up status of authorization and any additional documentation or information, if needed.
  8. Enter current authorizations and respond to internal/external inquiries relating to authorizations.
  9. Communicate medical complexity/acuity of pre-authorization and re-authorizations requested documentation from insurance companies to the Clinical Coordinator and Scheduler.
  10. Operate Wellsky, DDE, ECIN on-line to internet as needed; Fax, copy, etc.
  11. Assist with scanning insurance benefits coverage, pre-authorization and re-authorizations paperwork into the Wellsky system as needed.
  12. Maintain ongoing communication with other members of the care team on pre-authorization and re-authorization updates
  13. Maintain ongoing communication with billing team on pending authorizations and troubleshooting authorizations related issues.
  14. Perform other job duties and responsibilities as assigned by the Home Health Director of Revenue Cycle including participating in performance improvement activities, i.e., performance improvement groups.

POSITION QUALIFICATIONS/REQUIREMENTS:

  • At least one (1) year authorization experience preferred with Home Health.
  • At least one (1) year insurance benefits coverage verifications experience preferred with Home Health.
  • Able to work autonomously with minimum supervision.
  • Demonstrated organizational skills and detail-oriented.
  • Demonstrated problem-solving and decision-making skills.
  • Demonstrated computer skills preferred.
  • Demonstrated time management skills.
  • Demonstrated interpersonal skills.
  • Demonstrated verbal and written communication skills.
  • Able to communicate in English.
  • Able to work as a team member.
  • Ability to manage time effectively in a hybrid work environment.

Empath Health values diversity as it strengthens our community and care. We embrace the diversity of cultures, thoughts, beliefs and traditions of our employees, volunteers and people we are honored to serve across our network. Our diverse staff reflects our community and each day, we work to be respectful, sensitive and competent with each other and those in our care. In every journey, we are dedicated to achieving comfort, dignity and exceptional care. Those of all backgrounds are welcome and encouraged to apply with us or seek our care and services.

Our commitment to patient, client, staff and volunteer safety is a cornerstone of a High Reliability Organization with a focus on zero harm. Participation in the seasonal influenza program is a condition of employment and a requirement for all Empath Health employees.

Providing compassionate, full life care is an honor we take seriously at Empath Health. Join our team and make a positive impact in the community!

EEO is the Law

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You will have the option to create a profile by clicking on Sign in above the Job Details.

We recommend creating a profile which will enable you to check on the status of your application and apply for other positions later on.

You can either Upload an existing cover lettter or Paste/type your cover letter. The cover letter has to be 50 characters minimum to proceed.

To submit a resume you have the option on using the Resume Builder, uploading an existing resume or paste/type your resume below .

We recommend using the Resume Builder if you do not have a digital copy of your resume. With the Resume Builder you can add an Objective (career goals, desired job title), Work Experience, Education Skills, Certifications, Awards and Memberships as well as References.

You can attach up to 3 additional documents to your job application for further consideration.

Resume Tips

  1. Put your name, phone number and email at the top of the resume.
  2. Include a summary (if you have several years of experience) or include an objective.
  3. List all of your relevant work experience, start with your current or most recent employment first.
  4. Give precise employment dates (month and year).
  5. Double-check your resume for accuracy before submitting it.