Help At Home Looking for (Remote) Managed Care Authorization Coordinator for Illinois at Remote Full Time

Help at Home is hiring a Managed Care Authorization Coordinator! Someone with Managed Care or insurance experience is a plus!

Help at Home is the nation’s leading provider of high quality care and support solutions. Our goal is to enable the highest level of personal independence and meaningful lives for our clients. Help at Home is committed to delivering a gold standard in care through our attentive and well-trained staff who support our clients comfortably and safely within their homes and communities.

This position oversees verification of coverage and waiver eligibility for home health services. Processing of authorization documents properly and timely, also answer requests of initial and additional authorizations related to the processing all documents. This position reports directly to the MCO Authorization and MCO Eligibility Supervisor.

Responsibilities

• Keep up with high volume and fast paced environment.
• Verify eligibility and process on all authorizations according to contract regulations, calculations and requirements.
• Meet all initial and additional authorization request deadlines.
• Investigate, track and report status of all authorization discrepancies with the MCO and branch offices.
• Develop and maintain working relationships with team, branch offices, as well as with contract-holder provider representatives.
• Communicate progress and any trends or issues with supervisor on a regular basis.
• Complete miscellaneous duties, tasks and projects as assigned.
• Responsible for verifying waiver coverage and to ensure client’s correct contract coverages in entered into data base correctly.

Qualifications:

• Prefers 2-3 years of experience with Managed Care insurance .
• Experience with Medicaid eligibility verification and authorizations .
• Hospital, home care or other high volume/fast pace healthcare office experience .
• Demonstrate knowledge of Microsoft Office including Outlook and Excel.
• Demonstrate problem-solving abilities as well as being able to work independently and in a team environment.
• Prefers knowledge or experience with websites Medi, PSS, Availity and MCO portal

Education and Experience:

• High school diploma or equivalent required.
• Two to three years of related experience in a authorization role in a healthcare setting.
• Experience working in a team environment.

Physical Requirements:

• Prolonged periods sitting at a desk and working on a computer

The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions upon request.

Help At Home is an Equal Employment Opportunity (EEO) employer and welcomes all qualified applicants. Applicants will receive fair and impartial consideration without regard to race, sex, color, religion, national origin, age, disability, veteran status, genetic data, or religion or other legally protected status.

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions upon request.

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