Aveanna
Lead Authorization Specialist_
Aveanna, Seal Beach, California, United States, 90740
Lead Authorization SpecialistApplyRefer a FriendBackJob DetailsRequisition #:197023Location:Seal Beach, CA 90740Category:Medical Billing/CollectionsSalary:$18.00 - $26.00 per hourPosition Details*Remote Position*Position Overview The Lead Authorization Specialist works in collaboration with Authorization Specialists and oversees the insurance authorization process for patient services. The Lead Authorization Specialist facilitates the coordination between healthcare providers, clinical teams, and insurance carriers to ensure that necessary approvals are obtained, and payment processes are streamlined.Essential Job FunctionsSupervise and coordinate the insurance authorization process for requested patient services, ensuring timely approvals are obtained.Manage performance and effectiveness of authorization team members and initiate appropriate performance improvement actions as necessary.Manage escalations from authorization team members, providing guidance for resolution and follow-up actions with locations as necessary.Initiate effective communication with the patient's insurance provider upon receiving referral information from the clinical team, specifically for services requiring pre-certification or authorization.Proactively engage with insurance carriers to facilitate the timely receipt of all required payment information, ensuring smooth processing of authorizations.Keep assigned authorization teams informed of any changes in requirements by insurance companies related to the authorization and eligibility, providing guidance and updates as necessary.Ensure the completeness of submissions by verifying all necessary information is included, adhering to the highest standards of accuracy and compliance.Maintain consistent communication with the authorization team throughout the authorization process, providing regular updates on the status of service requests with insurance carriers.Proactively identify and report any issues that may lead to an authorization lapse to location management for resolution, providing insights, and recommendations for improvement.Support, train, and mentor Authorization SpecialistsAdhere to the Aveanna Compliance Program, including following all regulatory Aveanna and accrediting agency policies.RequirementsHigh school diploma or GED2+ years of related experienceStrong computer skills (Word, Excel, Power Point)PreferencesBachelor’s degree in healthcare or related fieldBilingual; Spanish speaking a plusAdditional healthcare, medical office, or customer service experienceOther Skills / AbilitiesProficient in Microsoft suite of products including Outlook, Word and ExcelMust be able to adhere to confidentiality standards and professional boundaries at all timesSelf-starter, able to display the highest level of integrity and respect for confidentiality.Ability to exercise effective judgment and sensitivity to changing needs and situations.Must have strong organizational skills and be very detail oriented.Excellent written and verbal communication skillsProven ability to work independently at times and within a team.Demonstrated ability to prioritize multiple tasks to meet deadlinesDemonstrated ability to interact in a collaborative manner with other departments and teamsPhysical RequirementsMust be able to speak, write, read and understand English.Occasional lifting, carrying, pushing and pulling of 25 pounds.Prolonged walking, standing, bending, kneeling, reaching, twisting.Must be able to sit and climb stairs.Must have visual and hearing acuity.Must have strong sense of smell and touch.EnvironmentPerforms duties in an office environment during agency operating hours.Must be able to function in a wide variety of environments which may involve exposure to allergens and other various conditions.Other DutiesPlease note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.Vaccine RequirementAs an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all relevant jurisdictions, including required vaccinations and testing, subject to exemptions for medical or religious reasons as appropriate.Headhunters and recruitment agencies may not submit resumes/CVs through this website or directly to managers. Aveanna does not accept unsolicited headhunter and agency resumes, and will not pay fees to any third-party agency or company that does not have a signed agreement with Aveanna.As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all relevant jurisdictions, including required vaccinations and testing, subject to exemptions for medical or religious reasons as appropriate.Notice for Job Applicants Residing in California (veanna.com/CaliforniaPrivacyNotices.html)Apply