Authorizations Specialist

Authorizations Specialist

True Care is a licensed Home Care Agency providing outstanding homecare service in the New York Metropolitan area. Our passionate dedication to our clients sets True Care apart. We work with our clients individually to ensure their satisfaction and comfort with the paraprofessionals caring for them. It is our mission to continue to raise the standard of homecare services. We are committed to providing the highest level of care by maintaining excellence in staff, procedures, and responsiveness. The True Care team is healthcare professionals who are committed to helping our patients and caregivers experience the most excellent care.

Location: Full-time Monday-Friday 9 am-5 pm onsite in Brooklyn, NY

The Authorizations Specialist handles all aspects of authorizations for patient services and is the liaison between the company and contracted partners. He/she is responsible for ensuring data received from our contracts is accurate, verified and then entered into the system. The Authorizations Specialist ensures continuity of service by acquiring authorizations as needed and confirming eligibility for active patients under all lines of business.

Key Responsibilities:

• Responsible for reviewing insurance authorization forms for services provided to clients for corrections
• Monitor and track patient authorizations, informing supervisor of any expired dates
• Review and audit all authorizations for appropriate codes and units before entering into system
• Enter all confirmed authorizations into HHAeXchange and notify appropriate departments to continue with scheduling services
• Routinely verify insurance eligibility on contract websites and portals
• Routinely verify Medicaid eligibility on ePACES
• Follow processes and notify appropriate teams regarding lost eligibility or disenrolled members
• Run reports on upcoming expiring authorizations and follow processes to get increases for patient services
• Follow processes for paperless systems including E-fax data tracking and scanning all documentation to centralized location
• Participate in data retrieval for claims appeals and requests for payment
• Liaison between the insurance companies and the agency
• Maintain appropriate logs or reports according to company standards
• Provide superior customer service through phone/fax management skills, computer documentation of codes and information for claims

Required Qualifications:

• High School Graduate/ GED equivalent
• Knowledgeable of basic office software technology; ePACES, and eligibility verification
• Must be able to communicate professionally over the phone, in person and through email communication
• 1-2 years of Homecare experience is a plus
• Experience in HHAeXchange is required
• Able to successfully work well in a team and also independently on certain projects and tasks

Benefits:

• Health, dental, and vision insurance
• 401(k) with company match
• PTO and paid holidays
• Professional development opportunities
• Mission-driven work in an innovative healthcare space