Case Management Authorization Specialist IP

OverviewBe inspired. Be rewarded. Belong. At Emory Healthcare.At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide:

Comprehensive health benefits that start day 1

Student Loan Repayment Assistance & Reimbursement Programs

Family-focused benefits

Wellness incentives

Ongoing mentorship, development, and leadership programs

And more

DescriptionRequirement:

Follows developed policies and procedures to obtain insurance eligibility and benefits by identifying correct insurance plan and determining coordination of benefits with minimal guidance.

Responsible for informing the care team and financial counseling of any discrepancies identified related to coordination of benefits and/or coverage as it relates to ineligible coverage, non-covered services or out of network status.

Secondary to verification of eligibility, provides notification of admission for inpatient and observation stays to the identified payer within the payers required timeframe in order to secure reimbursement for services provided.

The Case Management Authorization Specialist functions with minimal oversight and guidance with a general understanding of payor requirements as it relates to insurance verification, notification, and authorization.

Assists with providing technical and clerical support, as directed, to the Case Management team in order to timely transition patients into post-acute services within the allotted amount of reimbursable hospital days, as determined by the clinical authorization obtained.

Facilitates referral process, as directed, for securing post-acute care services which can include: Home health, Durable Medical Equipment, Rehab, Hospice, Long Term Care.

MINIMUM REQUIREMENTS:

High school education diploma or equivalent.

College degree preferred.

At least two years of experience in a healthcare setting is required.

Two (2) years of insurance verification, authorization, or related work preferred.

Additional DetailsSupporting a diverse, equitable and inclusive culture. Emory Healthcare (EHC) is dedicated to providing equal opportunities and access to all individuals regardless of race, color, religion, ethnic or national origin, gender, genetic information, age, disability, sexual orientation, gender identity, gender expression and/or veteran's status. EHC does not discriminate on the basis of any factor stated above or prohibited under applicable law. EHC respects, values, and celebrates the unique perspectives and backgrounds of all individuals. EHC aspires to create an environment of collaboration and true belonging for all our patients and team members. Emory Healthcare (EHC) is committed to achieving a diverse workforce through equal opportunity and nondiscrimination policy in all aspects of employment including recruitment, hiring, promotions, transfers, discipline, terminations, wage and salary administration, benefits, and training.ACCOMODATIONS: EHC will provide reasonable accommodations to qualified individuals with disabilities upon request. To request this document in an alternate format or to request a reasonable accommodation, please contact the Office of Diversity, Equity, and Inclusion.”PHYSICAL REQUIREMENTS (MediumMax 25lbs):up to 25 lbs, 0-33% of the work day (occasionally); 11-25 lbs, 34-66% of the workday (frequently); 01-10 lbs, 67-100% of the workday (constantly); Lifting 25 lbs max; Carrying of objects up to 25 lbs; Occasional to frequent standing & walking, Occasional sitting, Close eye work (computers, typing, reading, writing), Physical demands may vary depending on assigned work area and work tasks.ENVIRONMENTAL FACTORS:Factors affecting environment conditions may vary depending on the assigned work area and tasks. Environmental exposures include, but are not limited to: Blood-borne pathogen exposure Bio-hazardous waste Chemicals/gases/fumes/vapors Communicable diseases Electrical shock , Floor Surfaces, Hot/Cold Temperatures, Indoor/Outdoor conditions, Latex, Lighting, Patient care/handling injuries, Radiation , Shift work, Travel may be required. Use of personal protective equipment, including respirators, environmental conditions may vary depending on assigned work area and work tasks.Connect With Us!Connect with us for general consideration!Division Emory Univ Hosp-MidtownCampus Location Atlanta, GA, 30308Campus Location US-GA-AtlantaDepartment EHM Social ServicesJob Type Regular Full-TimeJob Number 143675Job Category Revenue Cycle & Managed CareSchedule 8a-4:30pStandard Hours 40 HoursHourly Minimum USD $20.10/Hr.Hourly Midpoint USD $26.13/Hr.Emory Healthcare is an Equal Employment Opportunity employer committed to providing equal opportunity in all of its employment practices and decisions. Emory Healthcare prohibits discrimination, harassment, and retaliation in employment based on race, color, religion, national origin, sex, sexual orientation, gender identity or expression, pregnancy, age (40 and over), disability, citizenship, genetic information, service in the uniformed services, veteran status or any other classification protected by applicable federal, state, or local law.