Hartford HealthCare
Location Detail:
9 Farm Springs Rd Farmington (10566) Shift Detail:
Hours: 7:30am-5pm (flexible hours) Days: Monday thru Friday (with rotation thru weekends and holidays) Start here at Hartford HealthCare and work where every moment matters! Hartford HealthCare at Home
doesn’t just take great care of our patients; we take great care of our Registered Nurses too! Our benefit options at Hartford HealthCare at Home are designed so you can care for yourself and your family, just as you care for others when you are here. Possibility of a sign‑on bonus based on eligibility. Job Summary:
Under the direction of the Prebilling and Authorization Manager, the Authorization Specialist performs all duties related to insurance verifications and prior authorizations for Home Health and Hospice services in a timely manner. Maintains documentation and insurance portal access and ensures accurate records in the Electronic Medical Record (EMR) – Home Care Home Base (HCHB). Communicate updates in insurance or regulatory guidelines to the manager and relevant departments. Key Areas Of Responsibility: Verifies insurance eligibility and prior authorizations accurately and timely for Home Health and Hospice clients. Reviews daily workflows, communicates updates to leadership, ensures authorization details are entered for timely billing, and reports coverage issues as needed. Obtains prior authorizations from insurance companies by phone, fax, or portals; submits required clinical documentation; accurately records authorization details in HCHB; and communicates any changes in authorization or eligibility to regional leadership. Independently prioritizes work, keeps skills and knowledge current to serve as an insurance resource, protects confidentiality, and communicates professionally with payors, clients, and colleagues. Ensures accurate account management and timely authorization requests per payor guidelines, reports delays to the Manager, supports denial audits, and collaborates with hospital departments on billing and authorization processes. Assists with training of new prior authorization staff and other duties as assigned. At Hartford HealthCare , we are focused on supporting our colleagues. Our Registered Nurses have the opportunity to practice at the top of their license using research, innovation and evidence-based practices. We offer our Graduate Registered Nurses clinical instruction and additional learning opportunities as they complete the Nurse Residency program. Qualifications Minimum Requirements High School Graduate/Diploma Preferred Requirements Two – four years experience within a healthcare setting and familiarity with payor sources, processes and guidelines Education High School Graduate/Diploma Experience Minimum one year experience working with insurances and prior authorizations, preferred Two – four years experience within a healthcare setting and familiarity with payor sources, processes and guidelines Licensure, Certification, Registration – Language Skills Strong written and verbal English communication skills are necessary. Knowledge, Skills And Ability Requirements Experience and knowledge of insurances and prior authorizations Experience in Home Health and Hospice services and guidelines Knowledge of Government, Medicare Advantage and Commercial payors Experience with payor portals and clearinghouses Ability to effectively and professionally communicate with physicians, clinical and administrative staff, managers, patients and insurance companies Must be self-motivated and have the ability to work independently and within a team Excellent verbal and written communication skills Demonstrates excellent computer skills Must demonstrate strong organizational skills Senioriy level Entry level Employment type Full-time Job function Health Care Provider Industries Hospitals and Health Care
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9 Farm Springs Rd Farmington (10566) Shift Detail:
Hours: 7:30am-5pm (flexible hours) Days: Monday thru Friday (with rotation thru weekends and holidays) Start here at Hartford HealthCare and work where every moment matters! Hartford HealthCare at Home
doesn’t just take great care of our patients; we take great care of our Registered Nurses too! Our benefit options at Hartford HealthCare at Home are designed so you can care for yourself and your family, just as you care for others when you are here. Possibility of a sign‑on bonus based on eligibility. Job Summary:
Under the direction of the Prebilling and Authorization Manager, the Authorization Specialist performs all duties related to insurance verifications and prior authorizations for Home Health and Hospice services in a timely manner. Maintains documentation and insurance portal access and ensures accurate records in the Electronic Medical Record (EMR) – Home Care Home Base (HCHB). Communicate updates in insurance or regulatory guidelines to the manager and relevant departments. Key Areas Of Responsibility: Verifies insurance eligibility and prior authorizations accurately and timely for Home Health and Hospice clients. Reviews daily workflows, communicates updates to leadership, ensures authorization details are entered for timely billing, and reports coverage issues as needed. Obtains prior authorizations from insurance companies by phone, fax, or portals; submits required clinical documentation; accurately records authorization details in HCHB; and communicates any changes in authorization or eligibility to regional leadership. Independently prioritizes work, keeps skills and knowledge current to serve as an insurance resource, protects confidentiality, and communicates professionally with payors, clients, and colleagues. Ensures accurate account management and timely authorization requests per payor guidelines, reports delays to the Manager, supports denial audits, and collaborates with hospital departments on billing and authorization processes. Assists with training of new prior authorization staff and other duties as assigned. At Hartford HealthCare , we are focused on supporting our colleagues. Our Registered Nurses have the opportunity to practice at the top of their license using research, innovation and evidence-based practices. We offer our Graduate Registered Nurses clinical instruction and additional learning opportunities as they complete the Nurse Residency program. Qualifications Minimum Requirements High School Graduate/Diploma Preferred Requirements Two – four years experience within a healthcare setting and familiarity with payor sources, processes and guidelines Education High School Graduate/Diploma Experience Minimum one year experience working with insurances and prior authorizations, preferred Two – four years experience within a healthcare setting and familiarity with payor sources, processes and guidelines Licensure, Certification, Registration – Language Skills Strong written and verbal English communication skills are necessary. Knowledge, Skills And Ability Requirements Experience and knowledge of insurances and prior authorizations Experience in Home Health and Hospice services and guidelines Knowledge of Government, Medicare Advantage and Commercial payors Experience with payor portals and clearinghouses Ability to effectively and professionally communicate with physicians, clinical and administrative staff, managers, patients and insurance companies Must be self-motivated and have the ability to work independently and within a team Excellent verbal and written communication skills Demonstrates excellent computer skills Must demonstrate strong organizational skills Senioriy level Entry level Employment type Full-time Job function Health Care Provider Industries Hospitals and Health Care
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