Job Description

Job Title: Authorization Coordinator
Job ID: 715546
Status: Full-Time
Regular/Temporary: Regular
Hours:
Shift: Day Job
Facility: Home Nursing Agency
Department: Billing - Reimbursement
Location: 201 Chestnut Avenue, Altoona PA 16603

Description

Purpose:
The mission of Home Nursing Agency is dedication to the highest quality of customer service delivered with a sense of warmth, kindness and individual pride.

Responsibilities:
  • Demonstrate support of the Agency's Mission, Principles, and Values, Ethics, & Standards of Behavior
  • Educate and require adherence to performance improvement processes and initiatives
  • Expand knowledge and expertise through educational resources and literature review
  • Investigate and resolve individual customer accounts: Generate, research, respond to, distribute, and track Billing Communication forms Assist in the process to generate, submit, and manage administrative appeals in accordance with each payer's guidelines
  • Maintain and protect customer and Agency confidentiality
  • Maintain personal productivity by demonstrating satisfactory attendance and punctuality
  • Obtain and maintain current knowledge of The requirements, standards, practices, and preferences of the Agency services The requirements, standards, practices, and preferences of the payers of those services The computer systems used to manage reimbursement and customer records
  • Promote personal and co-worker safety during work duties
  • Provide insurance verification consultation and assistance, as needed or requested, to: Verify and document customer's insurance coverage(s), with relevant payers Communicate insurance information to Agency staff regarding benefit coverage, deductions, co-pays, and special instructions Maintain current database of all Agency insurance payers, with specifics about the insurance provider
  • Represent and participate in Agency professional and community activities as requested
  • Serve as the principle Agency contact for selected payers to: Negotiate with payers to secure reimbursement rates, initial and ongoing authorizations for services Communicate authorization information and payer expectations and/or instructions to appropriate Agency staff Provide the payers with clinical progress reports regarding the customer's care, treatment, and progress toward goals/outcomes Implement monitoring and tracking mechanisms to compare authorizations with services provided

Qualifications

Education: Graduate of an accredited Medical Secretarial School 
 Experience: Three years health care experience within a hospital, medical doctors office, other related health care organization  
Certification/Licensure: Licensed as required by professional discipline, as applicable 
Computerization Skills: Proven competency in clinical application system and software and Microsoft Office. 
 Travel: Access to transportation in Agency service area with valid PA drivers license and proof of auto liability required

Licensure, Certifications, and Clearances:
UPMC is an equal opportunity employer. Minority/Females/Veterans/Individuals with Disabilities

Salary Range: $14.45 to $23.02

Union Position: No

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