Job Description:

Why a career with Independence First?

When you join Independence First you will be part of a collaborative and passionate team. You will also enjoy lucrative benefits! Independence First was selected as one of Milwaukee Business Journal's Best Places to Work in 2022.

Independence First is looking for awesome people to join our team!

You  are just the person to join our growing team if you are...

* Looking for an Excellent Benefits Package

* Passionate About Helping Others

* Prefer Bilingual in English, Spanish, Hmong or Arabic (Not required)

Benefits include:

* 12 sick days, 13 vacation days and an additional 11 paid holidays a year

* Employer paid Dental, Life Insurance (twice annual salary), AD&D, Short and Long Term Disability

* Health Insurance Benefits (partially employer paid, depending on coverage)

* Low-cost Vision Insurance

* Employer-matched 403(b) Retirement Account

* Fitness Center On-site

* Annual Health Risk Assessment

* Annual Flu Shot

* Comprehensive Wellness Program

* Tuition Reimbursement Program

POSITION DESCRIPTION

Position: Service Authorization Specialist, Personal Assistance Services

Status: Full-Time, Hourly

Reports to: Compliance Supervisor

Position Summary: Responsible for the administration of consumer prior authorizations, re-certification and consumer eligibility and reimbursement to ensure continuous service.

Position Expected Hours of Work: This is a Full-Time position. Days and hours of work are Monday through Friday, 8:00 am to 4:30 pm. Occasional evenings and weekends.

Essential Functions of the Position:

1. Overall, responsible for tasks associated with continuous coverage for Independence First consumers in compliance with Wisconsin Department of Health Services Administrative Code and payer requirements.
2. Responsible for submission, tracking, and documentation of prior authorizations to multiple Medicaid, Long-Term Care Program, and Managed Care Organization payers
3. Communicate with Medicaid, Long Term Care Programs (Family Care, Partnership and IRIS) and Managed Care Organizations to ensure authorizations are correct and received in a timely manner.
4. Responsible for inputting and updating consumer coverage information in multiple databases.
5. Maintains on-going knowledge of payer source requirements.
6. Responsible for submitting and tracking the 485 MD orders and ensuring that the documents are signed and received prior to the beginning of the certification period.
7. Collaborate with other PAS staff and teams to ensure continuous coverage for consumers.
8. Identify barriers to successful prior authorizations and develop strategies to overcome barriers.
9. Requests for medical records/documentation as needed for prior authorizations and hospital verification requests.
10. Responsible for variety of tasks associated with the operation of the PAS department.
11. Must have a firm belief in consumer control, the Independent Living Philosophy and Independence First’s Vision Statement.
12. All other duties as assigned

Work Environment

1. The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
2. The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Disclaimer:

The above statements reflect the general details necessary to describe the principle functions of the occupation described and shall not be construed as a detailed description of all the work requirements that may be inherent in the occupation.

As an Independent Living Center, it is required that 51% of Independence First’s staff have a disability. Independence First is an equal opportunity employer and strongly encourages people with disabilities to apply for this position.