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Authorization Representative (Mass Health)

Innovive Health
Medford, MA Full Time
POSTED ON 2/23/2025
AVAILABLE BEFORE 5/19/2025

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At Innovive Health, our mission is to provide best-in-class home healthcare services to patients with chronic behavioral health issues and complex medical needs. Our team is made up of skilled caregivers, nurses, and operations staff who collaborate to create innovative technology and data-driven solutions while ensuring the best outcomes for our patients. If you enjoy working one-on-one with patients outside of a clinical setting, Innovive Health has the opportunity you're looking for. Innovive Health offers work-life balance, a competitive benefits package, and a competitive salary based on experience. If this sounds like the type of work you're looking for, apply today!

POSITION SUMMARY :

The Authorization Representative is a part of a fast-pace and dynamic department that plays a crucial step in making sure that the patients are eligible to receive our services. The individual filling this position is an ambitious, hands-on problem solver, and effective communicator that will support the achievements of the team. The role includes the following : insurance verifications, obtaining authorizations, and patient eligibility.

What you'll do : Obtain prior authorization or pre-certification of services to be rendered as required by each individual payor.Answer incoming telephone calls and triage to appropriate personnel as indicated.Complete and manage all paperwork or supportive documentation required for performing effective billing.Re-verify patient eligibility, monitor insurance lifetime caps and prior authorization periods.Resolve patient / payor issues in a timely manner.Run various reports to keep up with patient caseload and Utilization Review MaintenanceParticipate in departmental, clinical and company meetings as requested.Participate in required training including, but not limited to, in-service and educational programs.Performs other duties as assigned.What you need :

Associate degree or equivalent in related work experienceMinimum of 1 years' experience in an office settingProficiency in Microsoft OfficeHealthcare experience is preferredWe believe our employees are our greatest asset! What we offer :

Competitive salary based on experienceComprehensive benefits package includes medical, dental, vision, disability, and life insurance24 days of paid time offPaid Company Holidays401k with company matchDayforce Wallet - voluntary benefit that gives you access to earned payWellness programTuition reimbursementOnline CEU creditsExcellent career growth opportunitiesInnovive Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

Other details

Job Function Non-Managerial OperationsPay Type HourlyTravel Required No

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