Intake And Authorization Specialist

Reports to: Director of Clinic Operations

FLSA Status: Exempt/Full-Time

Compensation: $18 to $22/ hour

Location/Travel: Based out of our San Antonio – Seybert clinic, occasional local errands as needed

Job Summary:

The Intake andAuthorization Specialist at Circle of Care is a key member of the authorization team. This individual provides the intake of referrals, pre-certification, or verification of benefits and physical orders. Provides information regarding services to providers and parents. They are also responsible for insurance requests and Authorizations for any child covered by an insurance policy who needs our care. Working in a fast-paced, growing organization, this position is focused on the ever-growing needs of the team in line with the CofC standard of patient care. This position will rely heavily on communication, team-oriented, and multi-tasking abilities.

Circle of Care provides in-clinic pediatric occupational, physical, and speech therapy services in Texas. EBH was created with the mission of empowering families by providing the most effective Applied Behavior Analysis (ABA) services, to ensure that learners with autism and other developmental disabilities reach their maximum potential. Together, these organizations have set out to provide the best care across pediatric occupational, physical, speech therapy, and ABA services.

Join our compassionate and knowledgeable team of professionals as an Intake and Authorization Specialist and help us grow!

Duties and Responsibilities:

• Assist with identifying performance improvement processes for efficiency – the need is great out there! Help us help children get the services they need.
• Help assess and obtain any necessary authorizations from the insurance company
• Interact with points of contact throughout the insurance companies we have contracts with to facilitate the authorization process in a timely fashion.
• Work closely with physicians and other providers to gather the necessary information for the patient to obtain proper services
• Maintain orders for clinical staff members following Agency policies and procedures
• Provide general information regarding in-clinic services to the community and physicians
• Provide accurate intake information on all referrals
• Obtain pre-authorization if required by the payor
• Contact third-party payers to pre-certify and obtain benefit information as needed
• Contact physicians for orders on all new referrals; contact physicians for approval and orders for changes in existing patient Plans of Treatment
• Effectively track & document referrals to ensure services are rendered in a timely manner
• Review concurrent forms and check that all supporting documents are complete and submitted.
• Participate in daily team huddles to ensure communication is optimal.
• Regularly follow up on authorization requests to keep the process moving
• Track all authorizations and monitor timelines to escalate cases as needed
• Notify the Director of Clinical Operations regarding admissions, and re-admissions for scheduling in the clinic
• Additional duties as requested

Competencies:

• Attention to detail
• Excellent oral and written communication
• Results Oriented
• Customer Focus
• Problem -Solving
• Organizational Skills

Education and Experience:

Required:

• Associate degree or equivalent; or a minimum of 1 to 3 years of insurance and Authorization-related experience
• Knowledge of Microsoft Outlook, Office, Word, and Excel and EMR experience, teams
• Experience with commercial/Medicaid insurance payors, authorizations, and credentialing
• Experience with communicating with insurance companies
• Previous knowledge/work in a medical office
• Working in a clinical-based environment

Preferred:

• Minimum of one year experience in an authorization/insurance role
• Bilingual
• Experience working with medical terminology
• Experience working in a growing fast-paced organization

Circle of Care provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.