SEH-AUTHORIZATION SPECIALIST

General Purpose of Job:

Provides support and performs a variety of secretarial/administrative tasks for clinical director and Empower Staff. Duties include developing and maintaining systems, , typing forms/correspondence, preparing and reviewing departmental documents and reports, assisting individuals in person and over the phone, scheduling appointments, anticipating the needs of the patients and maintaining departmental records and files. Assumes responsibility for accurately gathering pertinent information and registering clinical patients. Responsible for obtaining Authorizations for patients, as well as contacting insurance for extensions.

Essential Duties:

This job description is intended to cover the minimum essential duties assigned on a regular basis. Caregivers may be asked to perform additional duties as assigned by their leader. Leadership has the right to alter or modify the duties of the position.

• Displays a high level of organization and is capable of effective and efficient multi-tasking.
• Schedules clinical evaluations, follow-up appointments, and other patient/client appointments. Obtains patient's/client's demographics, medical, and insurance information and records information.
• Obtains insurance authorization, co-pays, co-insurance, deductibles, out of pocket expenses, and number of allowed visits. Collects all necessary information needed for proper billing.
• Assumes responsibility for accurately registering clinical patients; focusing on customer relations and promoting good will between patients, physicians, hospital and clinical staff.
• Contacts insurance companies regarding extensions and continuations of clinical services and communicates with clinical staff.
• Working knowledge of diagnosis codes and treatment codes in order to obtain proper authorizations.
• Responsible to inform clinical staff of covered and non-covered services, limitations of benefits, and situations regarding out of pocket cost for the patients. Also, appropriate standards for patient's allowable visits, time frames, and how to minimize mistakes with reimbursement.
• Assumes responsibility for the rehab denial, registration and claim/edit work queues.
• When requested establishes and maintains departmental records and files.
• Attends staff meetings and in-services as assigned. Records meeting minutes as directed.
• Supports and serves as a role model for our mission, vision, values and customer service initiatives. Adheres to the organization's policies & procedures, and compliance guidelines.
• Maintains up to date knowledge of insurance company requirements for authorizations and referral processes.
• Provides training and support to new and existing authorization/referral caregivers.
• Performs other duties as assigned.