Role Description
The Associate, Authorization is a position responsible for ensuring that patient care services are ready to bill accurately and in a timely manner. The primary responsibility of the role is to obtain authorization for care from insurance carriers and provide denial support. This position will serve as a liaison between the service office providers, insurance carriers, and revenue cycle management functions. A high level of customer service and support is required to obtain insurance authorization and effectively communicate clients’ coverage.
Qualifications
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Exemplifies characteristics of The BAYADA Way: compassion, excellence, and reliability.
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Four (4) year college degree.
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Prior healthcare and/or home care experience preferred.
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One (1) year of relevant work experience obtaining authorizations and verifying eligibility is preferred.
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Demonstrated record of strong interpersonal skills and building relationships.
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Self-motivated, flexible, and versatile.
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Strong customer service skills.
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Demonstrated record of goal achievement.
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Basic PC skills required to perform job functions.
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Proven ability to multitask and manage competing priorities.
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Ability to sort and arrange information and files in an appropriate manner.
Requirements
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Demonstrate and communicate the core values of BAYADA and The BAYADA Way.
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Develop working knowledge of BAYADA’s mission, services, people, organization, policies, and procedures.
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Provide backup support for routine support questions.
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Meet metrics that support BAYADA’s goals and objectives and measure effectiveness.
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Prepare reports and presentations using Microsoft Office (Word, Excel, PowerPoint, etc.).
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Support annual audits and compliance reviews, as needed.
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Learn various aspects of the organization through technology training, hands-on learning, cross-training, and site visits.
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Support authorization and eligibility workflow within appropriate system/s.
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Communicate effectively and maintain positive working relationships with insurance companies, referral sources, service offices, etc.
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Perform related duties, or as required or requested by supervisor.
Other Responsibilities
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Manage a caseload and provide customer support for dedicated service offices.
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Perform utilization management (review plan of care and utilization requests) to ensure proper number of days are requested.
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Respond timely to requests and/or escalate review of denied requests.
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Communicate with insurance companies via portals, phone, or other third-party systems to request authorization.
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Support supplies and referral management.
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Provide any support to revenue cycle teams regarding authorization discrepancies or payor requirement changes.
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Submit appeals to insurance companies.
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Obtain denial letters from primary insurance companies when a secondary carrier is being billed yearly or as needed.
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Review and interpret authorization for services rendered to mitigate claim/EDI errors and denials.
Benefits
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Base Pay: $21.64/hour
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BAYADA offers a comprehensive benefits plan that includes:
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Paid holidays, vacation, and sick leave
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Vision, dental, and medical health plans
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Employer paid life insurance
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401k with company match
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Direct deposit
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Employee assistance program
Company Description
BAYADA believes that our employees are our greatest asset. As an accredited, regulated, certified, and licensed home health care provider, BAYADA complies with all state/local mandates. BAYADA is celebrating 50 years of compassion, excellence, and reliability.
