What are the responsibilities and job description for the Managed Care Authorization Specialist position at MJHS?
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The Managed Care Authorization Specialist has overall responsibility for communicating and coordinating with managed care providers to ensure appropriate reimbursement services rendered to Menorah residents. This includes but is not limited to obtaining ongoing authorizations for services, submitting clinical documentation to support level of care and facilitating the appeal process and supporting the case management department.
The Managed Care Authorization Specialist has overall responsibility for communicating and coordinating with managed care providers to ensure appropriate reimbursement services rendered to Menorah residents. This includes but is not limited to obtaining ongoing authorizations for services, submitting clinical documentation to support level of care and facilitating the appeal process and supporting the case management department.
- Maintain ongoing communication with Case Managers to resolve any issues which may impact service delivery
- Coordinates with Menorah staff to ensure that all needed documentation is submitted timely.
- Maintains continued authorization for Menorah residents while covered by Managed Care plans and as needed.
- Participates in Case Management Rounds and collaborates in the discharge planning process.
- One-year prior managed care experience preferred
- Prior experience in a health care setting preferred
- Familiarity with utilization management/case management
- Microsoft Office
- Ability to present well, both verbally and written
Salary : $46,640 - $58,300