- Receive requests for prior authorizations and ensure that they are properly and closely monitored within company set standards
- Review accuracy and completeness of information requested and ensure that all supporting documents are present
- Assist with medical necessity documentation to expedite approvals and ensure that appropriate follow-up is performed
- Collaborate with other departments to assist in obtaining prior authorizations/appeals
- Manage correspondence with insurance companies and internal customers as required
- Document all interactions with insurance companies within pharmacy system
- Document all prior authorization information including approval dates, billing units, procedure codes, and prior authorization number in patient profile
- Review insurance denials and submit appeals (as permitted by payor)
- Proactively work on prior authorizations that are due to be expired
- Secure patients' demographics and medical information by using discretion and ensuring that all procedures are in sync with HIPAA compliance and regulation
- Conducts job responsibilities in accordance with the standards set out in the Company's Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards Completes all required duties, projects and reports in a timely fashion on a daily, weekly, or monthly basis per the direction of the leadership
- Provides quality service by enforcing quality and customer service standards.
- Contributes to team effort by accomplishing related results as needed
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Authorization Specialist - Fresno, United States - Compassionate Care Home Health Agency
Description
Benefits:
401(k) matching
Dental insurance
Health insurance
Paid time off
Parental leave
Vision insurance
Are you looking for a place where you can make a genuine difference in people's lives?
Search no further
Compassionate Care Home Health Agency has five office locations (Fresno, Visalia, Modesto, Merced, and Bakersfield) and services eight counties throughout the Central Valley (Stanislaus, Mariposa, Merced, Madera, Fresno, Tulare, Kings, and Kern) - and we're growing fast Our top priority is maintaining our culture of respect and love for our patients and team, alike. Our commitment to our core values allows us to be a provider and employer of choice. We understand that our employees are key to providing quality care and are our most important resource.
We actively seek career-oriented individuals, to whom we offer job security and upward mobility when appropriate - based on merit and performance. We proudly employ an accomplished team of professionals and our team is as diverse as the communities we serve, representing different ethnicities, religions, ages, national origins, and sexual orientations.
Join us today and grow with us
We are currently seeking to fill the Authorization Specialist position in our Fresno office:
-Compensation:
-Hourly rate range: $19.00-$22.00/ hour (negotiable: based on experience, skill level, availability, etc).
-Salary option available, as well.
-Opportunity to accumulate overtime.
Your assigned duties will include:
All other tasks- when needed and as directed by your supervisor, Ms. Madison Rowell-Authorization Specialist Supervisor.
Employees and patients are equally precious to us. Your happiness is our happiness - we offer you the following benefits for any full time position:
●Dynamic, fun, team-oriented work environment
●Unparalleled company culture
●Local company with soul
●Countless growth and development opportunities
● Flexible Schedules
● Medical, dental and vision insurance
● Mileage Reimbursement at current Federal rate
● Gas reimbursement for those in company cars
● PTO
● Paid Holidays
● Paid Sick Days
● 401K
● And so much more
Compassionate Care was established in 2003 in Fresno County and has grown into Central California's most trusted home health agency. Compassionate Care provides in-home medical, rehabilitative, and support services by seasoned professionals with comprehensive clinical training and robust hospitality experience.
