Medical Authorization Specialist

Location

Sandy, UT | United States

Job description

Our Hospice Service company has an immediate need for an experienced Medical Authorization Specialist who is familiar with the intricacies of insurance companies, including, but not limited to Medicare and Medicaid. The ideal candidate will be compassionate, naturally helpful and able to work a problem to its successful conclusion.

At Suncrest Hospice our goal is to change the expectation of hospice care in your area by providing exceptional care and service to our patients. This is achieved by allocating the resources to increase our staff to patient ratios, thereby increasing clinical visits while lowering clinician caseloads. We are proud to be a Community Health Accreditation Partner (CHAP) certified hospice. If you have a commitment to providing the highest quality of care to patients and their families, we would like to hear from you!

• Actual Work/Life Balance
• Competitive Pay
• Benefits Package including Medical, Dental, and Vision insurance
• Paid Time Off
• 401k plan with employer match and 100% vesting after 90 days of employment
• A culture with an emphasis on appreciating and valuing the team member
• The opportunity to be part of a rapidly growing national company, with possible position upgrades

• Obtain appropriate authorizations specific to patient’s care and continued reauthorization as needed.
• Follows up on delayed or denied authorization requests and escalates for resolution.
• Creates detailed documentation and maintains/stores the authorization paper trail.
• Provide insurance company with all required information within contractual timelines.
• Verify insurance information and provide specific details of patient benefits in record; include deductible, out-ofpocket, co-pays, co-insurance, and amounts met, as well as in- and out-of-network benefits.
• Verify secondary insurances if primary insurance is not covered 100%
• Assist with in-network agencies if insurance is out-of-network
• Verify Medicare eligibility and ensure accuracy of Medicare number in the patient record

• Must have a high school diploma or equivalent.
• One year of third-party eligibility verification experience is preferred.
• One year experience in insurance authorizations is preferred.
• Must be organized with the ability to communicate effectively.
• Effectively work with other team members in order to complete tasks efficiently and collaboratively

HPSSC

Job tags

Salary