Authorization Specialist in Addison, TX at Elara Caring

Job Description

The Authorization Specialist accurately and effectively coordinates staffing and patient scheduling duties for the agency as well as interacts with the billing department by obtaining insurance authorizations, and verifying eligibility and benefits as needed.

Key Accountabilities

Position Duties and Responsibilities: Component Proportion 80%

• Accurately enters patient episode schedules and changes/updates into data base and notifies appropriate staff to these changes/updates. Verifies early/late episodes as well as re-verifies the Insurance policy number for the patient prior to case conference.
• Arranges for staffing of new referrals utilizing appropriate clinical staff based on discipline and geographical area. Assist with verifying patient benefits and inputs into the database as back up.

• Effectively provides administrative management of commercial insurance patients (benefit verification, reauthorization, scheduling).
• Tracks patient status, with assistance from the Marketing team, until patient is admitted.
• Other duties as assigned.

Reporting/Planning: Component Proportion 20%

• Provides reports/census and updated status at case conference.
• Reviews the staff weekly schedules for appropriateness and notifies the ADON of any scheduling issues/concerns.
• Distributes weekly schedule to staff members every Friday as needed.
• Attends weekly case conferences and follows up with scheduling issues/concerns.
• Promotes effective, positive and respectful communication to patients, staff members, other healthcare professionals and referral sources.
• Promotes agency vision and administrative policies by maintaining a high level of ethical standards.
• Presents a professional image of self and agency as outlined in the employee handbook.
• Other duties/projects as assigned.