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Lead Authorization Coordinator (Home Care)
Adventist Health Roseville, CA
$54k-70k (estimate)
Full Time | Elementary & Secondary Education 1 Month Ago
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Adventist Health is Hiring a Lead Authorization Coordinator (Home Care) Near Roseville, CA

Our home health and hospice agencies are located throughout California, Hawaii, Oregon and Washington. They serve the entire community and offer personalized in-home care, and many have been recipients of Home Care Elite awards.
So whether you're looking for the buzz of a large city, the tranquility of nearby mountain bike trails or something in between, we encourage you to explore our organization.

Job Summary:

Monitors and performs audits on all authorization management functions. Serves as working supervisor for authorization team. Provides guidance to staff within the latitude of established work area and policies. Works on assignments that are considerably difficult requiring judgment in resolving issues or in making recommendations. Works with sensitive and confidential information, often involving the interpretation of policies and procedures to guide use. Responsible for management of authorizations of all activities requiring referrals for services provided, serves as the key coordinator and liaison whose primary role is to expedite the collection process. Responsible for patient insurance management and outreach, with regards to deductibles and authorization to bill.

Job Requirements:

Education and Work Experience:

  • High School Education/GED or equivalent: Preferred
  • Associate’s/Technical Degree or equivalent combination of education/related experience: Preferred
  • Five years' relevant experience: Preferred

Essential Functions:

  • Obtains home health and hospice authorizations and retroactive authorizations as needed. Communicates with providers, clinical staff and caregivers to obtain information required for authorization approval.
  • Verifies eligibility of members and determines benefit coverage. Gathers clinical documentation needed from case management and other team members to obtain continued authorization.
  • Problem solves with authorization team members. Orients new hires to authorization team processes.
  • Prepares reports, special projects and auditing as requested. Promotes authorization best practices and standardization.
  • Performs other job-related duties as assigned.

Organizational Requirements:

Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations, including, but not limited to, measles, mumps, flu (based on the seasonal availability of the flu vaccine typically during October-March each year), COVID-19 vaccine (required in CA, HI and OR) etc., as a condition of employment, and annually thereafter. Medical and religious exemptions may apply.

Job Summary

JOB TYPE

Full Time

INDUSTRY

Elementary & Secondary Education

SALARY

$54k-70k (estimate)

POST DATE

03/11/2024

EXPIRATION DATE

05/10/2024

WEBSITE

adventisthealth.org

HEADQUARTERS

ROSEVILLE, CA

SIZE

1,000 - 3,000

FOUNDED

2019

CEO

JAMES E PEDERSEN

REVENUE

$200M - $500M

INDUSTRY

Elementary & Secondary Education

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About Adventist Health

Feather River Outpatient Ctr is an executive office company based out of 6283 Clark Rd # 4, Paradise, California, United States.

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