Authorization Specialist

The Authorization Specialist supports branch management by verifying initial and ongoing payer authorization and eligibility of home care services. The position reports to the Business Manager.

• This is a full time in-office position, Monday - Friday 8am - 5pm.

• Paid Time Off
• Paid Holidays
• Recognition Program
• Employee Referral Program
• 401k - 100 % Vested Upon Eligibility
• Medical, Dental, Vision, Life, AD&D, Pet insurance
• Mobile provider discounts
• Tuition Reimbursement

• Verifies insurance eligibility and authorization of current and potential home care clients in an accurate and timely manner.
• Communicates payer authorization and eligibility information to Clinical Manager, Business Manager, or designee.
• Enters insurance authorization and eligibility information into Company software.
• Notifies branch management regarding lack of payer coverage or other service non-coverage issues.
• Performs re-authorization and eligibility checks in a timely manner.
• Communicates and documents information regarding change in authorization and eligibility to branch management.
• Monitors and ensures all client authorization of services are current and quantity and type of services provided meet payer requirements.
• Reviews and ensures appropriate processing of authorizations.
• Sends informational correspondence to the payer.
• Maintains professional, positive, and effective communication with payers, clients, Corporate and branch employees.
• Maintains confidentiality of all information pertaining to clients, families, and employees.
• Consults with branch management and clinical employees.
• Performs other related duties and responsibilities as assigned.
• Maintains knowledge and education to remain current, efficient, and productive as a home care insurance and payer resource to the branch.
• Demonstrates self-direction to prioritize and accomplish job responsibilities.
• Participates in the after-hours on-call process to assure client care policies and procedures are followed and staffing issues are resolved.

Light to moderate - primarily desk work with frequent phone use; some bending, stretching. Ability to work long hours and to tolerate some variability in hours. Able to operate simple and complex office equipment. Exerting 20 to 50 pounds of force occasionally, 10 to 25 pounds of force frequently, and greater than negligible up to 10 pounds of force constantly to move objects.

Physical demand requirements are in excess of those for light work.

• Minimum of two years of experience in insurance authorization, billing, business administration. Health care and home care experience preferred.
• Knowledge of third-party payer regulations including Medicare, Minnesota Medical Assistance, Veterans Affairs (VA), and private insurance.
• Ability to promote and maintain a positive attitude and encourage others to do the same.
• Strong organizational skills and the ability to work independently with minimal supervision.
• Demonstrates ability to make appropriate judgments as it relates to the payer authorization process.
• Strong written and oral communication skills.
• Basic computer skills with the ability to learn new software. Knowledge of Word and Excel is a plus.
• Have U.S. Citizenship or evidence of valid Alien Work Permit.
• Pass initial and ongoing background studies and screenings including but not limited to those of the Minnesota Department of Health and the Federal Office of the Inspector General’s List of Excluded Individuals and Entities.

Adara Home Health, Inc. is committed to fair and equitable compensation practices. The base salary range for this position in the U.S. is $42,000 - $53,000 per year. A candidate's salary is determined by various factors including, but not limited to, relevant work experience, skills, certifications, job level, supervisory status, and location.