Authorization Specialist Home Care and Hospice

Job Description

Responsible for coordinating eligibility and authorizations for home care and hospice services for managed care patients, which includes establishing and maintaining the patient’s plan of care, establishing and maintaining positive relationships with managed care customers and related referral sources.

• Verifies insurance coverage and obtains initial authorizations for services and seeks re-authorization for ongoing and additional services.

  Works with Director or Nursing and staff clinicians to gather, collate, and report patient care summary information to managed care Case Managers with other insurances.

  Maintains comprehensive working knowledge of managed care contractual relationships and ensures that patients are admitted and services are delivered in accordance with contract provisions.

  Works with members of the billing team to ensure that managed care customers are billed according to Case Manager Agreements.

  Establishes and maintains positive working relationships with current and potential managed care customers.

  Promptly responds to managed care customer’s requests and concerns.

  Assists in building community, customer, and payer and patient perceptions of Excell Home Care & Hospice as a high quality provider of services.

  Maintains comprehensive working knowledge in the field of managed care and shares information with appropriate organization personnel.

Qualifications

• Experience in home health and hospice insurance authorizations or billing preferred.

Additional Information

All your information will be kept confidential according to EEO guidelines.