Non-Clinical Authorizing Specialist

Description

Compensation: $21.00 per hour or more depending on experience

Location: Grand Junction, CO

Full-Time, Monday

Here's Why Our Team Likes Working with Us:

• Benefits eligible at 30+ hours per week.
• Medical, dental, vision, and 401K
• Supplemental insurance available
• Matching 401k
• Paid Time Off (PTO)

Position Summary

On behalf of CNS Cares (“CNS” or “Company”), the Non-Clinical Authorizing Specialist will ensure the request, follow-up and submission of patient records and authorizations. The Non-Clinical Authorization Specialist will also track approvals and follow up with DOL processing delays. The Non-Clinical Authorizing Specialist will prepare documentation, reporting, and assist management as needed.

Essential Functions

Employee must have regular attendance/punctuality, be able to work with others at all levels of the Company and be completely honest. Other assigned duties include, but not limited to:

• Collaborates with the patient, State Administrators, and other clinical staff to coordinate authorization requests and follow-up for initial start of care (or switchover) patients.
• Responsible for timely submission of start of care patients to DOL.
• Ensures accurate tracking through maintenance of spreadsheets and databases.
• Enters authorizations into the EMR to ensure accurate scheduling and billing.
• Maintain and adjust care periods to reflect any changes made by the DOL to authorizations.
• Tracks continuation of care information into the EMR to ensure no interruption in scheduling.
• Monitors the DOL Portal for any approved patient’s submissions and communicates approvals between team members.
• Assists with all VA patients: SOC, Renewal, VA Requests, and Issues.
• Provides assistance to the Authorization Team as needed.
• Collects and communicates pertinent, timely information to payers to ensure reauthorization of patient’s home health care services.
• Actively involved in the process improvement activities to achieve the optimal clinical, financial, operational, and satisfaction outcomes.
• Participates in assigned quality assurance committee(s) and interdepartmental projects when needed or requested.
• Provides accurate and complete documentation with rationale to ensure reauthorization of patients.
• Other duties as assigned.

Requirements

Related Competencies

Language Skills:

Must be able to read, analyze, and interpret general business practices, policies and procedures. Must be able to write business correspondence. Must be able to effectively respond to questions from groups of managers, clients, customers, and the public.

Decision Making:

Identify and understand issues, problems, and opportunities; possess ability to analyze data from different sources to draw conclusions; utilize effective approaches for choosing a course of action or developing appropriate solutions; take action that is consistent with available facts, constraints, and probable consequences.

Business Acumen:

Through the use of related law and industry data, proactively identify Company risks and institute policies and/or procedures to ensure compliance.

Education/Training

· Associate degree or equivalent combination of education and experience.

· Experience and knowledge of Department of Labor, and other payor sources, and in-home healthcare preferred.

Clearances

The following background checks are conducted:

• Criminal background
• Driving Record
• OIG Exclusion List
• Sex Offender Registry

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