Authorization Specialist- Managed Care Progra - Miami - Agape Network

Description

Authorization Specialist - Managed Care Program

This role involves working with a multidisciplinary team to gather clinical documentation justifying medical necessity according to Medicaid and Medicare guidelines.

1. Confirming authorization needs and taking appropriate actions.
   
2. Prioritizing authorizations based on urgency, complexity of procedures,
   and scheduled dates of service.
3. FOLLOWING UP WITH INSURANCE COMPANIES TO ACCELERATE RESPONSES AND EXPEDITE URGENT/EMERGENCY AUTHORIZATIONS.
4. Gathering clinical information while applying medical necessity criteria/guidelines

   ,POLICY PROCEDUREAND CLINICAL JUDGMENT TO RENDER COVERAGE DETERMINATION/RECOMMENDATION/DISCHARGE PLANNING ALONG THE CONTINUUM OF CARE

5. Maintaining confidentiality of patient care and business LIFE IS SHORT LET'S CHANGE IT!.C O M P L E T I N G A U T H O R I Z A T I O N PHONE CALLS EVERY 7 DAYS FOR PATIENTS IN THE RESIDENTIAL PROGRAM . d ocuments approved authentication content included [IT]
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