Authorization and Billing Specialist

Maximum Care, Inc., is seeking an Authorization and Billing Specialist to Join Our Team.

Maximum Care, Inc. has been in business for Over 40 years, supporting the elderly, disabled, and Participants with Intellectual Disabilities.

Maximum Care, Inc. Mission:

Our mission at Maximum Care, Inc. is to provide quality and respectful care consistent with the direct care worker process of ensuring safe, compassionate, ethical, and compliant care while upholding the client's dignity and rights, as well as those of the family members. At Maximum Care, Inc., we will foster an environment that encourages learning and development for professional growth among staff and office employees and administer our home care services cost-efficiently and effectively.

Our employees enjoy a work culture that PROMOTES diversity, inclusion, and equity. EOE

Maximum Care Inc. benefits include:

• Personal Time Off
• Medical Benefits
• Supplemental Insurance
• Competitive compensation
• Bonuses
• Ongoing education
  
  

Responsibilities:

• Manage and obtain authorizations for home care services provided to clients
• Review and enter authorizations into the system accurately and promptly, follow up on any missing authorizations, and coordinate with various stakeholders, including internal operations, case coordinators, and insurance companies, to facilitate a smooth authorization process
• Follow up on missing authorizations by contacting operations, clients, and insurance companies to obtain the necessary documentation
• Monitor and ensure that client authorizations are current
• Notify management if there are issues with coverage or non-coverage
• Verify insurance eligibility and authorization for new and existing clients, ensuring timely follow-ups with insurance companies to expedite approvals
• Communicate with the staffing and billing department regarding the status of client authorizations and provide assistance with any authorization-related questions or concerns
• Maintain professional communication with clients, payers, and other employees regarding the status of client authorizations and addressing any authorization-related questions or concerns
• Maintain detailed and accurate records of all authorizations, including documentation of communications and follow-up activities
• Assist in researching payments received from insurance companies related to billing denials for authorization or eligibility items, ensuring that the organization remains compliant and efficient in its operations
• Assist with the billing process, including rebilling and claim adjustments
• Provide regular reports on billing data
• Keep track of the outstanding balances to ensure complete, on-time payments
• The position is directed by goals and deadlines, which require excellent organization and time management skills
• Perform other projects/duties as assigned by the administration
  
  

Qualifications:

• Two or more years of proven experience in home care billing and authorization process, preferably familiar with HHAX
• This position requires a detail-oriented individual who can efficiently handle the authorization process, ensuring that all necessary authorizations are secured before billing occurs
• Strong organizational skills and attention to detail, with the ability to simultaneously manage multiple tasks and priorities
• Excellent communication skills, both written and verbal, with the ability to interact professionally with clients, healthcare providers, and insurance company representatives
• Proficiency in using computer systems and multiple software applications
• Ability to work independently with minimal supervision and make sound judgments based on established guidelines and procedures
  
  

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