Authorizations Coordinator- Home Care Job Category : Operations Requisition Number : AUTHO02536 Showing 1 location Job Details Description Organizational skills with the ability to effectively prioritize and timely complete tasks.

Knowledge of medical terminology, CPT, HCPCS and ICD coding.-Coordinates and processes patient authorization to completion with precision, detail, and accuracy.

• Must be detail-oriented, possess the ability to multi-task and be opened to cross-functionally training in all departments.
• Authorization Coordinator is a highly patient-focused role that works directly with our branches, clinicians, Case Managers, Physicians / PCP(s), insurance representatives, outside vendors, and other medical personnel.
• Obtains and tracks all authorization and re-authorization as indicated from payer(s), scheduled visits for services ordered / requested in a timely manner-Proficient in Excel, Microsoft and Outlook-Reviews and resolves KanTime Authorization issues and faxes.
• Communicate with branches, and eligibility when patient insurance has changed.-Transmits documents provided by the agency (Pinnacle Home Care) OASIS, POC, orders provided by the referring facility or provider to support the authorization request throughout the life cycle of the patient treatment / episode.
• Coordinates and communicates with the appropriate department (Pinnacle) personnel and / or billing department regarding any changes or updates from the payer in a timely manner.
• Provide front-line support to agency (Pinnacle) for authorization dates in comparison to patient treatment (SOC) dates and scheduling issues that arise from authorization need.

Communicates professionally with inter-company departments on resolution of potential disputed items.-Effectively manage the authorization throughout the course of a patient episode to ensure that the patients treatment coincides with the authorization provided by the Insurance carrier.

• Assign any Office Authorization as needed for patient care to continue without delay, until authorization has been submitted and returned with a decision.
• Continuing work Zendesk, Kantime fax inquiries and incoming faxes throughout the day to update patient authorization status, and to adhere to any failed faxes in Kantime, for Payer(s) requiring more information to process authorization.
• Meet productivity goals as assigned by the Authorization Supervisor.-Maintain confidentiality of all patient information.

Responds to all inquiries with a resolution to concerns and or discrepancies.-Follows Pinnacle Home Cares Attendance Policy.

SKILLS REQUIRED Analyzing and reconciling complex issues and problems timely.-Constructively working when faced with high workloads and deadlines.

• Following directions and respectfully request clarification when needed.-Identifying needs and opportunities and present them to the supervisor with recommended solutions.
• Working independently with minimal supervision.-Preparing and analyzing appropriate reports and other business correspondence.
• Maintaining a positive outlook at all times.-Communicating in a clear, precise, and hospitable manner-Fostering two - way communication-Addressing customer concerns in a courteous and timely manner.
• Strong organizational and time management skills-Use of relevant computer systems Qualifications Skills Behaviors : Motivations : Education Experience Licenses & Certifications

Last updated : 2024-05-02