What are the responsibilities and job description for the Authorization Specialist position at All American Home Care LLC?
All American Home Care is seeking a detail-oriented and proactive Authorization Specialist to join our team. This role supports branch management by ensuring accurate initial and ongoing payer authorization and eligibility verification for our home care services.
Key Responsibilities:
Key Responsibilities:
- Verify insurance eligibility and authorization for current and potential clients promptly and accurately.
- Communicate authorization and eligibility details to Coordinators, CFO, and OM.
- Enter insurance demographic information and monitor ongoing authorizations in HHAeXchange.
- Notify management of non-coverage issues, perform timely re-authorizations, and process discharges.
- Review and ensure authorizations align with billed services.
- Handle payer correspondence, appeals, disputes, and remittances.
- Maintain compliance with HIPAA/state regulations while fostering positive communication with payers, clients, and branch staff.
- Demonstrate initiative in prioritizing tasks and continuously update knowledge to remain a resourceful payer expert.
- Participate in after-hours on-call as needed.
- Minimum 2 years of experience in insurance authorization, billing, or business administration (health care/home care experience preferred).
- Knowledge of Medicare, Medicaid, Waiver Programs, and third-party payer regulations.
- Strong organizational, communication, and decision-making skills.
- Ability to work independently with minimal supervision.
- Proficiency in computer skills; familiarity with HHAeXchange (UPR) and Excel is a plus.
- Successful completion of background studies and screenings.