Easter Seals Goodwill Northern Rocky Mountain Authorization Coordinator in Great Falls, Montana
Responsible for the completion of authorization and notification for third party and government payers for Home Care and Hospice patients. Coordinates/educates nursing staff and other health care providers on the authorization and notification process and requirements. Tracks, documents, and monitors authorizations and notifications. Implements checks and balance systems to ensure compliance. Duties include, but are not limited to:
Develops and maintains collaborative working relationships with payers and health care providers.
Reviews daily census to determine if payer requires authorization/notification. Understands insurance/payer policy language, benefits and authorization requirements upon admission, during episode/certification period of care and discharge including concurrent reviews while the patient is on service.
Initiates authorization and notification requirements for individual payers and communicates with payer sources in a timely manner to obtain necessary authorizations.
Documents and maintains patient specific authorization data within the required information systems.
Conducts follow-up calls as necessary to third party payers to complete authorization process validating that all episode days are authorized.
Conducts concurrent authorization with third party payers during the patients episode based on the last covered day.
Reports denials and/or delays in the authorization process to AVP Clinical, Program Manager and Director of Billing. May provide information to the patient on the appropriate appeal procedures for denials.
Demonstrated computer skills (Microsoft Word and Excel program experience preferred).
Ability to work independently
Handle multiple tasks simultaneously with competing priorities.
Educate and work with a diverse consumer population.
Concentrate and pay close attention to details.
Requires ability to sit for a majority of worked time while utilizing a personal computer and telephone.
Ability to move independently or with reasonable accommodation within the facility and community.
Applicant must be physically and mentally able to perform all requirements of the job.
Applicant must pass a background check.
1 year of medical insurance claims experience through patient accounts billing or claims management preferred.
Easterseals-Goodwill offers a comprehensive & competitive benefits package including:
Medical, Vision, Dental and Voluntary Insurance
401(k) Retirement Plan + up to 4% contribution
Paid Time Off (PTO)
Short Term Medical (STM)
Group Life & Long Term Disability Insurance
Flexible Spending + Health Savings Accounts
Voluntary Term Life Insurance
Extensive Wellness Program
10 % Discount on ESGW Services
20% Discount at Goodwill Stores
Easterseals-Goodwill is an Affirmative Action/Equal Opportunity Employer and encourages applications from the disabled, minorities, women, and veterans of the U.S. armed services. ESGW will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant.
Great Falls, Montana, United States