Monday - Friday, 8:15am - 5pm

HOW YOU'LL MAKE A DIFFERENCE:
At Alternate Solutions Health Network, we care for patients where they spend the majority of their time – in their homes. Today we care for patients who need skilled home care and hospice services. You won’t find our brand in many places because we partner with health systems, jointly running home health and hospice agencies that use their brand. This is part of our strategy. By being part of the health system team, we can ensure each patient has a well-coordinated care plan that remains consistent whether the patient is seeing their primary care physician, receiving treatment in a hospital, or under our care in the home.As an Authorization Specialist, you will take the lead in securing medical authorizations from third party payers (commercial and government) for post-acute services. The Authorization Specialist will be instrumental in obtaining written documentation, tracking, prioritizing and reporting outcomes of each authorization request.

WHAT WE OFFER:
We provide medical, dental, and vision insurance with flexibility for you to select what works best for you. Eligible teammates receive paid time off and may participate in the 401K, if they choose. Historically the company has matched 401K contributions which helps build your nest egg even faster. Finally, our benefit program includes company paid life, disability insurance, and a robust Employee Assistance Program.

HOW YOU'LL WORK:
You will interface directly with clinical staff, medical offices and insurance payors to ensure a seamless process to the patients receiving post-acute health care services.

MAJOR AREAS OF RESPONSIBILITY:
Customer Service: Communicates with patients, employees and vendors regarding services. Assists patients, their families and co-workers in understanding authorizations and eligibility
Operations: Checks eligibility for all payor types, assumes responsibility for all patient authorizations. Collects and records accurate patient information.
Compliance: Understands and practices agency policies and procedures and continually improves practices. Able to follow all legal rules and regulations

HARD & SOFT SKILLS:
Excellent communicator with a positive attitude.
Patience is a virtue when working with patients, families, physicians, and coworkers.
Attention to detail is critical, as is being observant and following directions.
Proficiency in Microsoft Excel, Word, and Outlook. Experience with Peachtree, HCHB and EPIC is preferred. Ability to learn new systems.
Problem solving and create solutions to drive to a course of action.

REQUIREMENTS:
High-School graduate or equivalent. Associates Degree preferred.
1 year of billing insurance experience in a health care environment.
Capable of all physical demands.

SUMMARY: The Authorization Specialist will take the lead in securing medical authorizations from third party payers (commercial and government) for post-acute services. The Authorization Specialist will be instrumental in obtaining written documentation, tracking, prioritizing and reporting outcomes of each authorization request. The Specialist will be in a position to interface directly with clinical staff, medical offices and insurance payors to ensure a seamless process to the patients receiving post-acute health care services.The Authorization Specialist provides pertinent information requested from insurance companies and documents authorization details obtained from insurance companies into the Medical Record and appropriate databases. Functions of this role performed timely and accurately, affect the outcome and direct impact on the collectability of account balances and patient satisfaction, and financial outcomes. The Authorization Specialist complies with all legal, Medicare & private insurance and company rules and regulations.

QUALIFICATIONS & ATTRIBUTES:
High school diploma or equivalent.
An Associate’s degree or higher preferred.
1 year of billing insurance experience in a health care environment.
Excellent oral and written communication skills.
Proficiency in Microsoft Excel, Word, and Outlook. Experience with HCHB is preferred. Ability to learn new systems.
Detail oriented with ability to manage multiple responsibilities and ability to prioritize responsibilities.

Responsibilities include
Checks eligibility for all payor types
Assumes responsibility for all patient authorizations
Collects and records accurate patient information
Processed obtained authorization into EMR system
Communicates with patients, employees and vendors in regards to services
Assists patients, their families and co-workers in understanding authorizations and eligibility
Makes recommendations to the Director of Patient Accounts regarding difficult payors with regards to authorizations.
Examines EMR for data to assist with timely Authorizations
Prioritizes pending authorizations according to need
Tracks and electronically saves Authorization and eligibility documents and progress
Proactively addresses Authorization Challenges
Understands and practices agency policies and procedures
Continually improves practices
Follows all legal rules and regulations
Attends in-services, educational programs and meetings as necessary

ESSENTIAL FUNCTIONS:
Arrives at assigned location on scheduled work day. Works according to designated hours.
Effective communication skills in representing the Company and patient in obtaining insurance authorization requirements.
Accurate and efficient data entry.
Performs duties consistently with the use of a computer, fax, copier and phone.
Dexterity & vision to complete documentation on a computer.
Completes and submits all required documentation within specified company requirements.

Job Type: Full-time

Benefits:

• Dental insurance
• Flexible schedule
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• Monday to Friday

Experience:

• Insurance verification: 1 year (Preferred)
• Medical billing: 1 year (Preferred)
• Prior Authorization: 1 year (Preferred)

Work Location: One location

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