Insurance Authorization Specialist (Hybrid)

JOB TITLE: Eligibility & Authorization Specialist
DEPARTMENT: Revenue Cycle Management
DIVISION: Gulfside Healthcare Services
REPORTS TO: Revenue Cycle Manager
Hybrid schedule available.
M-F 8am-5pm
LOCATION:
2061 Collier Parkway
Land O' Lakes, FL 34639
POSITION SUMMARY:
Reporting to the Revenue Cycle Manager, the Eligibility & Authorization Specialist is responsible for the review and processing of nursing home financial forms, DCF notifications, verification and authorization.
EDUCATION AND QUALIFICATIONS:

• High School Diploma/GED required, Associate’s Degree preferred.
• Knowledge of third party and governmental payer requirements in order to obtain authorization.
• Knowledge of Florida Medicaid requirements and processes.
• Competency in using all industry based software related to job responsibilities (Waystar, Ability, Availity, Medicaid, et al)
• Able to deal tactfully with patients, family members, referral sources and payers.
• Knowledge of Microsoft Excel.
• Knowledge of governmental regulations and billing guidelines.

ESSENTIAL JOB RESPONSIBILITIES:

• Completes insurance verification and regulatory requirements for referred patients for hospice, home health and palliative care. Re-verifies on admission and completes payor setup in chart.
• Completes hospice, home health and palliative care authorization requests on admitted patients and updates the electronic health record timely.
• Documents new, pending and re-authorization requests in EHR. Coordinates with primary care physician offices for HMO plans.
• File notice of election paperwork to Department of Children & Families for Medicaid patients.
• Communicate daily with nursing homes and complete the nursing home reimbursement form upon admission.
• Protects the confidentiality of patient and organization information through effective controls.
• The incumbents may be requested to perform job-related tasks other than those stated in this description.

Flexible work from home options available.