As an Intake & Authorization Associate, you'll manage daily reports, collaborate on Plan of Care visits, and ensure smooth re-authorization requests. Your attention to detail and communication skills will streamline interactions, making you instrumental in delivering top-notch patient care experiences. Join us and make a difference in healthcare coordination today!

Responsibilities:

• Compile and analyze daily reports on the status of patient authorizations.
• Monitor expiring MD 485 orders related to authorizations that are due or overdue.
• Collaborate with the Clinical Director to assess the necessity of Plan of Care (POC) visits.
• Prepare and submit re-authorization requests to relevant contracts, including all necessary documentation and calculations.
• Manage prior authorization appeals and pending retro authorization requests by liaising with appeals departments.
• Identify and rectify discrepancies in authorizations, including incorrect approvals and service code errors.
• Retrieve re-authorizations and authorization revisions from provider portals, processing them in KanTime/HHAeXchange with appropriate documentation uploads.
• Coordinate and dispatch pre-authorization requests for Medicaid patients, ensuring all required forms and documentation are included.
• Liaise with contract Case Managers regarding nurses' notes, missing documentation, service changes, and member eligibility.
• Verify member eligibility using ePACES/Maximus NYMC and contact insurance companies as necessary.
• Provide patient eligibility status reports to management for assessment of RN (Registered Nurse) assessment needs.
• Communicate with family members, social workers, MLTC enrollment departments, and MLTC case managers to gather required documents for service initiation.
• Keep management informed on potential referral patient status updates.

Experience:

• At least 2 years of relevant experience, preferably in Healthcare or Home Care.
• Familiarity with HHAeXchange is advantageous.
• Proficiency in Microsoft Office Suite.
• Strong verbal and written communication skills.
• Demonstrated professionalism and ability to handle confidential information.
• Exceptional attention to detail and organizational abilities.
• Bachelor's degree in healthcare administration or a related field preferred.

EEO POLICY

Greater NY Nursing Services provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. 

This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.