All American Home Care LLC
Authorizations Coordinator
All American Home Care LLC, Phila, Pennsylvania, United States, 19117
All American Home Care LLC is an EEO employer - M/F/Vets/Disabled
A.
Overseesthe initiation of services for all new All American Home Care consumers byinterfacing with the appropriate Managed Care Organizations.
B. Works inconjunction with other All American Home Care departments to coordinateconsumer and caregiver record accuracy in order to initiate or terminateconsumer services.
C. Maintainssystems including but not limited to HHA Exchange for all new, terminating andongoing consumers including eligibility and authorization checks.
D. Responsiblefor documenting and communicating with all parties involved notices ofeligibility issues included but not limited to consumers, care managers andMCOs.
E. Assistin billing for all consumers that are under the DPW/Promise system.
F. Obtainingand following up on authorizations.
G. Workingwith the care managers to provide the documentation requested for continuedauthorization.
H. Ensuresthat there is an authorization in place at all times for consumers undermanaged care plan.
I. Obtainauthorizations and monitor those authorizations for changes or exhaustion ofbenefits.
J. Runningauthorization and eligibility reports.
K. Verifiesmember eligibility and benefits.
L. Distributescorrespondence and other information to the appropriate parties or departments.
M. Maintainsappropriate logs, records, and reports of all authorizations submitted.
N. Completeeligibility checks on the 1st and 16th of every month.
O. Cross-traincolleagues, as needed.
P. Resolvesimple to moderately complex issues, corrects errors and refers complex issuesto supervisor.
Q. Followsup on all claims requiring prior authorization.
R. AssistsBilling Department with resolving unbilled claims.
S. Adjudicatesand resolution of claim rejections as needed.
T. Otherresponsibilities as assigned.
Qualifications•Minimum of Associates Degree required,Bachelor"'s Degree preferred or combination of experience.•2+ years experience in a Case Management orBilling support role to leadership staff.•Demonstrated capability maintaining strictconfidentiality with employee information.•Knowledge of principles and practices of basicoffice management and organization.•Strong typing and computer application skills.•Computer proficiency and working knowledge ofMicrosoft programs required.•Strong interpersonal and business partneringskills.•Good judgement and decision-making skills.•Must be well organized, accurate and attentiveto detail.•Excellent communication, public relations andfollow up skills.•Must be able to work independently and havestrong written and verbal communication skills.•Belief in the Home Care concept.
Please visit our careers page to see more job opportunities.
A.
Overseesthe initiation of services for all new All American Home Care consumers byinterfacing with the appropriate Managed Care Organizations.
B. Works inconjunction with other All American Home Care departments to coordinateconsumer and caregiver record accuracy in order to initiate or terminateconsumer services.
C. Maintainssystems including but not limited to HHA Exchange for all new, terminating andongoing consumers including eligibility and authorization checks.
D. Responsiblefor documenting and communicating with all parties involved notices ofeligibility issues included but not limited to consumers, care managers andMCOs.
E. Assistin billing for all consumers that are under the DPW/Promise system.
F. Obtainingand following up on authorizations.
G. Workingwith the care managers to provide the documentation requested for continuedauthorization.
H. Ensuresthat there is an authorization in place at all times for consumers undermanaged care plan.
I. Obtainauthorizations and monitor those authorizations for changes or exhaustion ofbenefits.
J. Runningauthorization and eligibility reports.
K. Verifiesmember eligibility and benefits.
L. Distributescorrespondence and other information to the appropriate parties or departments.
M. Maintainsappropriate logs, records, and reports of all authorizations submitted.
N. Completeeligibility checks on the 1st and 16th of every month.
O. Cross-traincolleagues, as needed.
P. Resolvesimple to moderately complex issues, corrects errors and refers complex issuesto supervisor.
Q. Followsup on all claims requiring prior authorization.
R. AssistsBilling Department with resolving unbilled claims.
S. Adjudicatesand resolution of claim rejections as needed.
T. Otherresponsibilities as assigned.
Qualifications•Minimum of Associates Degree required,Bachelor"'s Degree preferred or combination of experience.•2+ years experience in a Case Management orBilling support role to leadership staff.•Demonstrated capability maintaining strictconfidentiality with employee information.•Knowledge of principles and practices of basicoffice management and organization.•Strong typing and computer application skills.•Computer proficiency and working knowledge ofMicrosoft programs required.•Strong interpersonal and business partneringskills.•Good judgement and decision-making skills.•Must be well organized, accurate and attentiveto detail.•Excellent communication, public relations andfollow up skills.•Must be able to work independently and havestrong written and verbal communication skills.•Belief in the Home Care concept.
Please visit our careers page to see more job opportunities.