Managed Care Authorization Specialist

About the role

Evergreen Healthcare Group is seeking an experienced and dedicated Managed Care Authorization Specialist to join our team our corporate team. As a key member support team, you will manage concurrent authorization requests and tracking; communicate effectively with peers, payers, and facility staff to confirm efficient delivery of information; and assist with initial authorization requests as needed.

Responsibilities

• Data entry of patient information into the electronic medical record for patient billing.
• Collaborates with Admissions Teams for insurance verification and case management negotiations for patient/payer set ups.
• Maintains knowledge of reimbursement principles and pricing parameters.
• Provides and documents ongoing communication with payor case managers for updates/changes/authorizations.
• Recognizes and notifies supervisor of potential problem referrals.
• Available for on-call responsibilities as assigned.
• Handles client complaints in a fair and empathetic manner.
• Trains new hires and performs remedial training with current staff.
• Manages and monitors “to-dos” in Electronic Medical Record daily.
• Assists Supervisor with projects as assigned.
• Completes annual education requirements.
• Communicates the mission, ethics, and goals of the organization.
• Attends annual review and performs departmental in-services.

Requirements

• High school diploma or equivalent.
• Managed Care Insurance Verification and Health Care experience required, Medical Terminology desired.
• Three years’ experience of Managed Care Insurance Verification and Health Care experience, Health Information ot Admission/Intake services is preferred.
• Electronic medical record documentation experience preferred.

Skills

• Ability to maintain patient confidentiality.
• Ability to maintain regulatory requirements, including federal, state, local regulations, and accrediting organization standards.
• Excellent computers skills and application experience within a professional level Microsoft; advanced Excel, Word, Power Point, and Outlook skills required.
• Regularly attend and be punctual for scheduled shift and be in a condition suitable to perform duties of position.
• Ability to organize and prioritize work, use time efficiently, and complete work in a timely matter, guaranteeing that deadlines are met.
• Works at maintaining a good rapport and a cooperative working relationship with physicians, departments, and staff.
• Able to communicate effectively in English, both verbally and in writing.

Pay

• Competitive Pay

Benefits

• Health, Dental, Vision Insurance
• Generous PTO Package
• Employee Assistance Program
• Training & Development Opportunities

At Evergreen, we believe in creating a culture that values compassion