Insurance Authorization Officer
Category
Full Time
Locations
Lafayette Office
Job Summary
Primary function is to ensure and coordinate authorization of home health services from insurance companies / organizations.
Job Relationships
- Supervised by: Director of Nursing
- Workers Supervised: None
- Interrelationships: All members of the health care team
Responsibilities and Duties
- Completes initial and renewal applications for non-Medicare payor sources. Instrumental in completion of required documentation for establishing new payor sources.
- Communicates required information with Insurance Representatives to secure prior authorization of patient visit allowances. Communicates prior authorizations to clinical case managers in a timely manner to allow timeliness of patient scheduling.
- Monitors all authorized visits to ensure no authorized visits are made by any discipline, i.e., skilled nursing, physical therapy, occupational therapy, speech language pathology, medical social worker, or home health aides.
- Reviews documentation which has been requested by the insurance company prior to submission of the information to the insurance carrier. This task is provided in collaboration with the RN Case Manager.
- Additional tasks or assignments as delegated by the Administrator or Director of Nursing.
Qualifications
- Three to five years' experience in home health care preferred.
- Prior experience in working with insurance companies preferred but not required.
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