Become a part of our caring community and help us put health first
 

This is a full time position scheduled for 8 hour shifts, 5 days a week Monday-Friday from 9:30am-6pm CST / 10:30-7pm EST.

As a Healthcare Insurance Authorization Specialist, you will be responsible for:

• Daily audit of admission, discharge and other source documentation to ensure revenue is recognized appropriately and all conditions of payment are met.

• Verify patient eligibility and payor coverage guidelines to ensure that all necessary information is secured for timely, accurate revenue recognition

• Weekly generation of site revenue and resolution of batch errors and bill holds as appropriate.

• Weekly communication with site leadership detailing outstanding documentation or other issues resulting in a potential loss of revenue.

• Prepare and submit invoices to Accounts Payable for reimbursement and performs follow up to ensure accurate, timely payments are made to our facility partners

• Prepare, submit and follow up on authorization and re-authorization requests according to applicable state and commercial payor guidelines.

• Coordinate, review, and analyze documentation and data entry supporting Medicare, Medicaid, and commercial payer requirements to ensure accurate and timely billing

• Ensure all internal controls and related policies/procedures are implemented and followed in accordance to the accounts receivable requirements.

• Ensure all payer requirements are met accordingly, including pre-cert requirements, notification requirements, and level of care change required documents.

• Alerts appropriate team members at the Site regarding late or missing documents required for billing.

• Establish and maintain positive working relationships with Sites, Nursing Home Facilities, and AR Teams.

• Maintain the confidentiality of patient/client and agency information at all times.

• Maintain accurate and up to date information for all vendor and nursing facility contracts.

• Keep information in an orderly manner readily accessible for review. Presents status as requested.

• Assure for compliance with local, state and federal laws, Medicare regulations, and established company policies and procedures.

• Participate in special projects and performs other duties as assigned.

• Assist with training of newly-hired associates, as well as re-education of revenue teams as necessary.

• Act as an information resource for any hard revenue generation issues or system issues. Basically the subject matter expert.

• Assure the completion and coordination of work in an associate’s absence, or as needed to maintain departmental standards.

Use your skills to make an impact
 

Required Experience/Skills:

• One to two years related experience and/or training preferred.

• Two years Home Health care or Medical Office experience preferred.

• Knowledge of insurance reimbursement and authorization process preferred.

• Skilled in the use of computers and the Microsoft Office applications. 

• Two years college preferred.

Additional Information:

To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:

• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.

• Satellite, cellular and microwave connection can be used only if approved by leadership.

• Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.

• Home or Hybrid Home/Office employees will be provided with telephone equipment appropriate to meet the business requirements for their position/job.

• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

CenterWell Home Health offers a variety of benefits to promote the best health and well-being of our employees and their families. Our competitive and flexible benefits surround you with support t