Authorization Coordinator

“Every person deserves compassion, dignity, and the safety of a place to call home.”

Homelessness is the largest social and public health crisis in California. Illumination Foundation (IF) is a growing non-profit organization dedicated towards disrupting the cycle of homelessness by providing targeted, interdisciplinary services in our recuperative care centers, emergency shelters, housing services and children's and family programs. IF currently has 13 facilities with 22 micro-communities scattered across Orange County, Los Angeles County and the Inland Empire.

Job Description

The Authorization Coordinator will be responsible for tracking and keeping up to date on the authorizations for the Recuperative care and STPH services from intake to exit. This role will need to communicate with Site Medical Staff, Site Manager, and Case Management, Director of Operations and Associate Director of Medical Billing. The authorization coordinator is also responsible for auditing client charts to confirm Managed MediCal enrollment, assist clients with MediCal redetermination or enrollment paperwork.

Responsibilities:

CalAIM Authorizations and Benefits

• Responsible for tracking and submitting initial and ongoing authorizations for Recuperative Care and Short-Term Post Hospitalization Services
• Communicate with Medical Coordination Staff, Site Manager, and Case Management for client intake and exit updates
• Collect all supporting documentation necessary to submit authorization request
• Review monthly Calaim Recup and STPH Billing Report
• Communicate in a timely matter when a client is not approved for services and proceed with appeal or escalate need for a quicker exit
• Audit Illumination Foundation Calaim Recup/STPH client charts to confirm Managed MediCal benefits enrollment
• Perform insurance entry clean ups as needed
• Assist clients with MediCal recertification and enrollment and communicate with case management what is needed to help client complete application process
• Escalate issues and/or disqualification with team
• Demonstrate a strong understanding of MediCal and Managed MediCal
• Demonstrate sufficient knowledge of Social Services Agency and Department of Public Social Services processes and collaborate with organizations as needed
• Responsibilities subject to change upon company needs
• Communicate with tact and professionalism
• Be able to meet targets and work under pressure with a high volume of claims
• Maintain knowledge of industry standard CMS guidelines for Billing
• Must be motivated to work independently as well as in a group setting
• Fulfill Illumination Foundation’s Guiding Principles of Integrity, Humility, Sustainable Compassion, Quest for Knowledge and Critical Thinking, Client-Centered Care, Innovation, Advocacy, and Stewardship and Compliance
  
  

Minimum Qualifications/Preferred Experience:

• High School Diploma or equivalent
• 1-2 years' relevant experience
• Basic computer skills, including the ability to send and receive emails and summarize data in spreadsheets
• Valid CA Driver’s License and eligibility for company vehicle insurance
• Prior experience work in Electronic Billing Platforms and EHR systems
• Prior experience working with claims and communication with health networks
  
  

Benefits

• Medical Insurance funded up to 91% by Illumination Foundation (Kaiser and Blue Shield), depending on the plan
• Dental and Vision Insurance
• Life, AD&D and LTD Insurance funded 100% by Illumination Foundation
• Employee Assistance Program
• Professional Development Reimbursement
• 401K with Company Matching
• 10 days holiday PTO/year
• Paid vacation and sick days
• Potential eligibility for the Public Service Loan Forgiveness Program (PSFL) for federally qualified loans
• Proficiency in Microsoft (Mail, Docs, Sheets, Calendar)
• Associate's degree or higher
• Medical Billing Certificate
• Experience in Medical Billing and Primary Care Billing
  
  

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