Managed Care Authorization Coordinator

`TITLE: MANAGED CARE COORDINATOR

REPORTS TO: REVENUE MANAGER

RESPONSIBILITIES:

· Processes insurance authorizations/reauthorizations. Serves as a liaison between BVNA clinicians and third party case managers.

· Performs data entry of following and /or similar information into BVNA’s Netsmart software program and/or third party insurer systems:

• Patient demographic information
• Physician information
• Referral source information
• Insurance information
• Authorization/reauthorization information
• Disciplines/services requested

· Inputs data into Netsmart and prints appropriate forms. Processes updates and notifies third party insurers of changes.

· Reviews patient’s medical record and extracts accurate, pertinent information. Submits that information to third party Case Managers for authorization/reauthorization purposes.

· Updates Netsmart with authorization/reauthorization. Sends ‘task’ to provider when indicated.

· Responds to internal/external inquiries regarding authorizations/reauthorizations.

· Maintains records as appropriate.

· Maintains open communications with all parties (internal and external) throughout the continuum of care process. Demonstrates effective communication skills, utilizing the appropriate chain of command.

· Maintains high performance standards and serves as a role model to peers.

· Attends team and BVNA meetings. May serve on BVNA committees.

· May recommend changes/revisions to his/her Manager.

· Performs similar or related duties as assigned.

QUALIFICATIONS:

· High school diploma: Associates Degree in Business or equivalent preferred

· Two to three years related experience and/or training; or equivalent combination of education and experience.
· Possesses an up-to-date knowledge of third party payors, i.e., Medicare, Medicaid, Blue Cross Blue Shield, private insurances and Managed Care products

· Knowledge of medical terminology

· Clerical/secretarial/administrative skills

· Home health care experience preferred

· Ability to establish professional relationships and to communicate positively and effectively with others he/she interacts with in the course of job performance

· Positive, respectful attitude and excellent customer service skills.

· Computer literacy (EMR, Word, Outlook).

· Ability to work independently and problem solve

For a complete job description please visit our website at www.brocktonvna.org

Job Type: Full-time

Pay: From $22.00 per hour

Expected hours: 37.5 per week

Benefits:

• 401(k)
• 401(k) matching
• 403(b) matching
• Dental insurance
• Disability insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Retirement plan
• Tuition reimbursement
• Vision insurance

Weekly day range:

• Monday to Friday

Ability to Relocate:

• Brockton, MA 02301: Relocate before starting work (Required)

Work Location: In person