Case Management Authorization Specialist IP

Overview

Be inspired.  Be rewarded. Belong. At Emory Healthcare. 

At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be.  We provide: 

• Comprehensive health benefits that start day 1 
• Student Loan Repayment Assistance & Reimbursement Programs 
• Family-focused benefits  
• Wellness incentives 
• Ongoing mentorship, development, and leadership programs  
• And more 

Description

Requirement:

 

• Follows developed policies and procedures to obtain insurance eligibility and benefits by identifying correct insurance plan and determining coordination of benefits with minimal guidance.
• Responsible for informing the care team and financial counseling of any discrepancies identified related to coordination of benefits and/or coverage as it relates to ineligible coverage, non-covered services or out of network status.
• Secondary to verification of eligibility, provides notification of admission for inpatient and observation stays to the identified payer within the payers required timeframe in order to secure reimbursement for services provided.
• The Case Management Authorization Specialist functions with minimal oversight and guidance with a general understanding of payor requirements as it relates to insurance verification, notification, and authorization.
• Assists with providing technical and clerical support, as directed, to the Case Management team in order to timely transition patients into post-acute services within the allotted amount of reimbursable hospital days, as determined by the clinical authorization obtained.
• Facilitates referral process, as directed, for securing post-acute care services which can include: Home health, Durable Medical Equipment, Rehab, Hospice, Long Term Care.

MINIMUM REQUIREMENTS:

• High school education diploma or equivalent.
• College degree preferred.
• At least two years of experience in a healthcare setting is required.
• Two (2) years of insurance verification, authorization, or related work preferred.

Additional Details

Emory is an equal opportunity employer, and qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or other characteristics protected by state or federal law.

 

Emory Healthcare is committed to providing reasonable accommodations to qualified individuals with disabilities upon request. Please contact Emory Healthcare’s Human Resources at careers@emoryhealthcare.org. Please note that one week's advance notice is preferred.