Insurance Authorization Specialist - Full Time | Manito Home Health

Manages and oversees insurance verification and authorization process for the Agency, as well as end of patient episode auditing process. This position also monitors and recommends payer mix and uses discretion to evaluation if a referral is accepted or declined for insurance purposes.

DUTIES & RESPONSIBILITIES

• Maintains comprehensive working knowledge of Manito Home Health & Hospice contractual relationships and ensures that patients are admitted to contract provisions. Acts as a resource to clinical and administrative team regarding insurance and authorizations.
• Verifies patient eligibility and benefits for insurances at time of start of care, recertification, and monthly.
• Coordinates with clinical and administrative team on any authorization/eligibility issues.
• Obtains insurance authorizations for all insurances that require prior authorization for home health.
• Completes an administrative record audit following patient discharge and recertification and forwards abnormal results to Director of Clinical Services or their designee for clinical audit. Additional duties as assigned by Business Office Manager and/or Director of Operations.

The above statements are only meant to be a representative summary of the major duties and responsibilities performed by the employee of this job.  The employee may be requested to perform job-related tasks other than those stated in this description.

JOB REQUIREMENTS (Education, Experience, Knowledge, Skills & Abilities)

• At least three to five years of experience on health care operations.
• Demonstrated ability to supervise and direct professional and administrative personnel.
• Ability to market and deal tactfully with customers and insurances.
• Knowledge of corporate business management, governmental regulations, and private payer practices.
• Demonstrate good communications, negotiations, and public relations skills.
• Demonstrates autonomy, organization, assertiveness, flexibility, judgment, and cooperation in performing job responsibilities.

Benefits: Medical, Dental, Vision, 401k Plan Options, Employee Assistance Program, etc.

Salary: $27.00 per hour