What are the responsibilities and job description for the Authorization Specialist position at Family Resource Home Care?
Role Overview
Join our financial team as an Authorization Specialist, where you will play a crucial role in supporting both our financial and operational teams in management of state authorizations. This position is perfect for individuals who excel in collaborative environments and have a strong attention to detail. Your collaborative and financial skills will be essential in maintaining the integrity of our financial processes and fostering teamwork between operations, state case management staff and HQ finance.
Key Responsibilities
Join our financial team as an Authorization Specialist, where you will play a crucial role in supporting both our financial and operational teams in management of state authorizations. This position is perfect for individuals who excel in collaborative environments and have a strong attention to detail. Your collaborative and financial skills will be essential in maintaining the integrity of our financial processes and fostering teamwork between operations, state case management staff and HQ finance.
Key Responsibilities
- Authorization Management: Ensure preauthorization is received and eligibility is updated in state Medicaid systems.
- Documentation Management: Verify AXC sites are updated to reflect current authorization dates and units to avoid shield shifts.
- State Management Coordination: Work with operational teams and state case management staff to ensure timely updates for new auths, renewals, and communication of changes to active auths to avoid overserves and client disruption.
- Data Entry & Reconciliations: Perform weekly reconciliations between state systems (P1, MMIS, HSRM) and AXC to ensure services being provided match authorized services.
- Adjustments and Denials: Work with Finance team when adjustments or denials are received to review files and allow for rebills. Work with case managers as needed to appeal claims adjustments.
- Tracking: Keep track of all active auths, appeals, and rebills, and provide reporting to management.
- Process Improvement: Recommend ways to enhance efficiency and decrease overserves.
- Misc. Duties: Perform other related duties as assigned to support the efficient operation of the department.
- Proven experience (1-2 years) in authorization management (Provider One, MMIS, HSRM) and/or financial reconciliations
- Proficiency in Microsoft Office suite (Specifically Excel)
- Excellent communication and interpersonal skills.
- Ability to prioritize tasks and manage time effectively in a fast-paced growth environment.
- Attention to detail and accuracy in data entry and record-keeping.
- Strong analytical and problem-solving skills.
- Ability to work independently with minimal supervision and as part of a team.
- High school diploma or equivalent
- Previous experience in accounting a plus.
- Strong attention to detail and accuracy.
- Excellent organizational and time-management skills.
- Strong communication and interpersonal skills.
