Coordinator-Authorization (Full Time)

Job Description

POSITION SUMMARY: The Authorization Coordinator's primary responsibility is to perform stationary, telephonic communication for authorization of rehab services for managed care and insurance customers, with the goal to capture reimbursable managed care and commercial insurance revenue associated with outpatient services, in a timely and accurate manner to maximize timely billing.

This position involves a variety of assignments requiring confidentiality and familiarity with the operating details of the overall company.


RESPONSIBILITIES/ACCOUNTABILITIES:
Authorization:
1. Provide professional support to Genesis Rehab Services Operations personnel by obtaining all authorizations on all outpatient managed care and commercial insurance customers in accordance with HIPAA regulations in handling patient confidential information.


2. Understand each managed care and commercial insurance plan's authorization / referral process and medical necessity requirements. Update quarterly or as necessary.


3. Maintain an ongoing tracking log of all referrals' open authorizations / re-authorizations by facility by plan.


4. Navigate insurance plan portals to understand benefit data and patient specific information (primary care physician, etc.) and generate referrals and authorizations if necessary.


5. Communicate regularly and consistently concerning any patient or plan updates, via e-mail and telephone, to rehabilitation and / or facility representatives.


6. Maintain and verifies accuracy of records of correspondence, reports, and related matters.


7. Assist in compiling and distributing activity reports to supervisor.


a. Utilize proprietary Genesis software systems, e.g. ROX, etc., in order to accomplish all day- to-day tasks, and create the related electronic documentation in order to ensure access to information for all concerned.


8. Educate new rehabilitation and facility staff as necessary concerning the authorization process and the role of the Authorization Coordinator.



9. Work with Managed Care Billing and GRS personnel on billing / collection issues as required to accomplish payment for outpatient services authorized and rendered.


Administrative Support:
1. Provide administrative support to Genesis Rehab Services Operations. This includes but is not limited to:
a. Answer and screen phone calls and/or emails.


b. Type reports, memos, letters, etc. which often involves matters of a confidential and technical nature.


c. Prepare and maintain files of correspondence reports and related matters.


d. Assist in compiling and distributing all standardized departmental reports.


2. Upholds the GRS Promises:
be ethical
I will always act with integrity and honesty, and expect others to do the same. I will ensure my actions comply with the standards set forth by our Policies and Procedures Manuals and the Employee Handbook.


be respectful
I will treat others in the way I would like to be treated. I will appreciate and respect others' beliefs, and I will cherish our diversity.


be accountable
I will take responsibility for myself in my actions and my quality of work. I will hold others to those same standards.


be actively engaged
I will make a conscious effort to be an active part of our community. I will check email and RehabCentral regularly to keep up-to-date on important information. I will be aware of the numerous resources available to me as an employee.


take pride in my work - my company
I will be proud of the work I've done each and every day. I will always represent my company in a positive, professional manner both inside and outside of work.


embrace change
I understand that change is a necessary part of life. I will approach change with a positive attitude and will work with my team members to overcome any obstacles associated with change.


communicate compassionately
I will communicate in an appropriate, professional and timely manner. I will strive to be an active


listener by making an effort to hear not just the words another person is saying but, more impor- tantly, understand the total message being conveyed.


strive for excellence
I will continuously work to grow and develop myself as an employee. I will ask for assistance if I need it, and I will be open to receiving feedback from my manager.


celebrate
I will contribute to a positive work environment where my team members and I enjoy coming to work and celebrating each other's successes.


3. Performs other related duties as required.



CGRA


QUALIFICATIONS:

SPECIFIC EDUCATIONAL/VOCATIONAL REQUIREMENTS: 1. High school diploma or related experience is required for this position.2. Familiarity with insurance terminology is preferred.



Position Type: Full Time
Req ID: 331606
Center Name: Genesis Rehab Services