Authorization Specialist

  • Full Time
  • Anywhere
  • Posted 2 weeks ago

Job Description

 

Intake and Authorization Specialist

Location: Remote Oakland, CA

Contract / Temporary to Hire

$20.00 – $27.00 / Hourly

Our client has an immediate need for a full-time Intake and Authorization Specialist who is interested in joining an organization at the ground floor (early commercialization phase). This would be a contract to hire opportunity and remote. The candidate will be a front-line contact for our patients and referral sources and will facilitate the onboarding of new patients/customers through their intake and insurance benefits authorization/qualification process (including pre-authorizations, pre-determinations, out-of-network waiver requests, appeals, and patient intake and collection of Patient Authorizations, Prescription, Certification of Medical Necessity, treatment notes, and other documentation). The ultimate goal of the position is to expand patient access to Dayspring and convert referrals who are generated by sales and marketing efforts into customers.

Candidate must be a strong team player, agile learner, and self-motivated. They must deliver the essential job responsibilities, but also have the drive and talent to grow the role and grow with the company as it scales. The job requires strong administrative, organizational, and (oral and written) communication skills and specialized knowledge of insurance coding, coverage, and policy. The candidate must also be confident and resourceful when faced with challenges related to a start-up company. PAY starting at $20+

Position Responsibilities:

Processes all incoming referrals, interviewing client/referral source to secure demographic and qualifying data, and securing verification and authorization of benefits as appropriate.

Coordinates incoming and outgoing calls and emails from both referral sources and patient/customers.

Initiates and coordinates prior authorization requests to third party payers and maintains a working knowledge of third party payer guidelines. Follows up with third party payers as necessary.

Operates in CRM system (SalesForce.com) to record/document and manage patient protected health information.

Establishes and maintains positive working relationships with current and potential customers and referral sources and with other company resources including field sales and commercial operations.

Assists other Intake/Home Care Coordinators as directed by the Vice President, Strategic Market Access and Health Economics.

Practices and reflects knowledge of HIPAA, TJC, and other federal/state regulatory agencies affecting patients and our business.

Knowledgeable of compliance requirements for federally funded healthcare programs (e.g. Medicare and Medicaid) regarding fraud, waste and abuse. Brings any questions or concerns regarding compliance to the immediate attention of administrative staff. Takes appropriate action on concerns reported by department staff related to compliance.

Competencies:

Ethical Conduct

Detail Orientation

Time Management

Organization Skills

Data entry skills

Personal Effectiveness/Credibility

About You:

At least three years of medical experience; preferably in home medical equipment.

Minimum high-school degree. College degree preferred.

Has previous health care or home care related Intake/Authorization experience.

Knowledge of insurance requirements.

Requirements

Insurance, Insurance Authorization, Salesforce.com

To apply for this job please visit www.roberthalf.com.