Job Description

Overview:

HarmonyCares is one of the nation’s largest home-based primary care practices. HarmonyCares is a family of companies all dedicated to providing high-quality, coordinated health care in the home. This includes HarmonyCares, HarmonyCares Medical Group, HarmonyCares Home Health and HarmonyCares Hospice.

Our Mission – To bring personalized, quality-based healthcare to the home of patients who have difficult accessing care.

Our Shared Vision – Every patient deserves access to quality healthcare.

Our Values – The way we care is our legacy. Every interaction counts. Go the extra mile. Empower and support each other.

Why You Should Want to Work with Us

• Health, Dental, Vision, Disability & Life Insurance, and much more
• 401K Retirement Plan (with company match)
• Tuition, Professional License and Certification Reimbursement
• Paid Time Off, Holidays and Volunteer Time
• Paid Orientation and Training
• Great Place to Work Certified
• Established in 11 states
• Largest home-based primary care practice in the US for over 28 years, making a huge impact in healthcare today!

More details about the benefits we offer can be found at . 

Responsibilities:

The Central Authorization Specialist, Home Health and Hospice coordinates and processes all new and subsequent authorizations through verification of insurances, acquiring and entering accurate patient demographic and billing information, and submitting all insurance authorization requests in a timely and accurate manner as required by the payor.

Essential Duties and Responsibilities

• Complete all authorization related workflow tasks as required
• Verifies and accurately interprets patient benefits via online portals or telephone
• Timely and accurately enters all authorization numbers in billing system
• Completes all necessary items required to finalize pending authorizations; subsequently updates billing system with relevant changes to authorization status, frequency and effective dates
• Interpret chart notes in order to facilitate obtaining authorizations
• Collaborate with internal and external customers for a seamless authorization process
• Submits all re-authorization requests for additional or subsequent services
• Tracks and follows up on all re-authorizations in same manner as initial authorization
• Communicate to clinical and office staff updates regarding authorization feedback to promote continuous improvement
• Responds to all email and phone requests in a timely and professional manner
• Monitor monthly authorization denial volume and work to improve department performance
• Meet established service level agreement for authorization turnaround time and quality
• Understanding of patient treatment plans for purpose of obtaining authorizations
• Serve as the subject matter expert for insurance authorization and verification
• Complete and submit Medicaid enrollment forms for Hospice Medicaid patients
• Assist with Hospice Room and Board builds in HCHB, obtain Room and Board rate letters when necessary, review Room and Board facility invoices in comparison to payments received from insurance companies to ensure proper rates and services were billed/paid
• Performs miscellaneous job-related duties as assigned

Qualifications:

Required Knowledge, Skills, and Experience

• High School Diploma
• 2 years of related experience
• Maintain high-level confidentiality to sensitive data, HIPAA, etc.
• Familiar with multi state insurance verification requirements
• Ability to research and maintain multi-state insurance authorization requirements
• Ability to interpret insurance records and related documentation
• Organizational and time management skills, as evidence by capacity to prioritize multiple tasks
• Clear understanding in Microsoft Excel and Outlook
• Strong attention to detail, accountability, organizational and interpersonal skills
• Ability to partner with shared stakeholders to achieve mutual success
• Ability to work in fast paced environment
• Strong accountability to team environment
• Excellent communication and organizational skills, verbal and written (end user support documentation, policies and procedures, etc.)
• Work independently and exercise sound judgement in interactions with physician, payors, and patients and their families if required

Preferred Knowledge, Skills and Experience

• Additional coursework in healthcare administration, billing or medical terminology
• 3 years of experience in a medical clinical setting or training in a medical office or hospital setting
• 2 years of experience related to healthcare insurance verification and/or billing
• Knowledge of clinical terminology and coding
• General understanding of revenue cycle with an emphasis on billing, coding, charge capture and reimbursement

Posted Max Pay Rate: USD $20.84/Hr. Posted Min Pay Rate: USD $17.16/Hr. Pay Transparency: Individual compensation packages are based on various factors unique to each candidate, including skill set, experience, qualifications, and other job-related considerations. Notice:

HarmonyCares and HarmonyCares Hospice are not affiliated with Harmony Hospice Care. HarmonyCares Hospice does not conduct business in OH. HarmonyCares Hospice conducts business in MI, VA, WI, TX, IN, IL.

Job Tags

Holiday work, Full time,

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