Medicare Authorizations Coordinator/RCDS

****Ignite your Career with Med1Care!!****

Are you fun, driven, confident, with excellent communications skills?

Then this may be the opportunity for you! Be part of a company where you will be valued as an individual, developed as a professional, and obtain a healthy work-life balance.

Med1Care is looking for a Medicare Authorizations and RCD Coordinator for our Toledo office. Med1Care is a home health and therapy company which has been synonymous with quality patient care and service for over two decades earning the highest CMS award for patient quality with a designated 5 star rating.

Med1Care has once again been ranked as the Best in Toledo workplace. Our fast-paced, professional environment fosters the development of our employees to their full potential. When our employees grow and succeed, our business grows and succeeds.

Responsibilities:

• Follow-up on patient accounts when authorization is required.
• Follow-up on each account during care and on discharge for authorization - document in the electronic system.
• Escalate any potential disputes or denial of accounts to Director of Nursing or designee.
• Trends disputed claims by at least payor and physician.
• Trend by payor and service any authorization not obtained by end of day.
• Trend and track on denial prevention.
• Validates patient’s demographic and payer information with patient/family and notifies necessary parties immediately if any corrections are needed
• Validates that all commercial/managed care discharges have an authorization for status and level of care provided and notifies Director of Nursing or designee of variances
• Cases that require authorization are obtained daily by fax or phone and documentation is completed daily
• Escalate discharged cases at end of day that have no authorization or notification of dispute is provided by payor
• Concurrently make sure all clinical needed by payors and updates are provided by alerting Case Manager assigned to case
• Collaborate with Patient Access, Case Management, Managed Care and Business office to improve concurrent review process to avoid denial or process delays in billing accounts
• Other duties as assigned.

Minimum Education & Experience Requirements:

• HS diploma or GED
• Knowledge of Medicare coverage regulations, home health, and Federal Laws governing Medicare Certified Home health a plus.
• Ability to communicate both orally and in writing, with clients, clinical and non-clinical personnel.
• Excellent organizational skills
• Exceptional customer service and problem-solving skills
• Ability to multi-task, work under pressure with changing priorities and short deadlines and effectively handle a heavy workload.
• Proficiency in communication technologies (email, cell phone, etc.)
• Highly organized with ability to keep accurate notes and records.

Job Type: Full-time

Pay: $16.00 - $19.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Work Location: In person

Salary : $16 - $19