Authorization Specialist Supervisor Position Available In Davidson, Tennessee

Authorization Specialist Supervisor 2.9 2.9 out of 5 stars 6840 Carothers Parkway, Nashville, TN 37067 The Eligibility and Authorization Supervisor serves as Supervisory support in the back office of the organization, as well as support for current Authorization Specialists. The Supervisor assists in eligibility, verifications and authorization procedures, HCHB updates, monitoring, as well as supporting our Operational partners via telephone, e-mail, and teams. The Supervisor has an increased responsibility to act as the ‘Subject Matter Expert’ for all questions related to authorization processes and maintain fluid communication with branch leadership to ensure smooth & quick processing of eligibility, verifications, and authorizations for all patients. The goal is to support Operations and ensure the process is seamless for the patient with no disruption/delay in care. The Supervisor will oversee all Centralized Authorizations for Home Health and Hospice lines of business for the entire company.

This is an in-office position:

M-F 8A-5P

Located @ 6840 Carothers Pkwy Franklin, Tennessee 37067

Job Qualifications Education:

Some college, or higher education is preferred

Experience:

2-4 years or more in a healthcare or administrative role; prior eligibility and authorization experience required. Prior team lead or Supervisory experience preferred.

Knowledge and Skills:

Must be organized, detail-oriented, and possess effective communication skills both verbal and written. Must be capable of prioritizing and handing multiple tasks of critical important and function well in an atmosphere of stress. Possess knowledge of insurance payors within Home Health or Hospice Knowledge of Revenue Codes, CPT and ICD 10 required Must provide excellent customer service to clients and maintain professionalism. Knowledge of the EMR Home Care Home Base strongly desired. Knowledge of Authorization platforms such as Availity, Waystar, Carelon, NaviHealth, eServices etc.- required Proficiency with Word Processing and Excel. Effective interpersonal skills to facilitate work in a team environment. Ability to effectively manage multiple demands; working under moderate to high degree of pressure Ability to multi-task and problem solve Strong organizational skills Excellent leadership skills Strong decision making and self-motivation skills Ability to communicate with multiple agency staff effectively and clearly, while executing daily tasks. Must maintain the privacy and confidentiality of all staff and clients in line with HIPAA standards.

Transportation:

Reliable transportation. Valid and current auto insurance.

Travel:

10%

Essential Functions:

Interview, hire, commend and provide constructive feedback. Conduct performance reviews on a 90 day and annual basis and as necessary. Regularly provide feedback to staff and set goals for improvement. Assure staffing needs are met. Implement alternative staffing patterns as need arise taking into consideration budgetary constraints and performance requirements and restrictions. Assist with scheduling to ensure adequate coverage for timely workflow to ensure patient continuity of care. Process timecards in an accurate and timely manner. Respond to employee questions/concerns on an individual basis as needed. Conduct regular team meetings/huddles to apprise staff of changes and to address broader based program area issues and initiative. Actively see and schedule staff development opportunities Personally perform functions supervised. Represent the department in meetings related to Prior Authorizations. Coordinate the routine office environment and ensure adequate two-way communication under the guidance of the Director of Revenue Optimization Report and monitor compliance of policies and procedures according to Medicare/Insurance guidelines and Company policies. Quickly and accurately process patient eligibility, insurance verifications, and prior authorizations for home health or hospice. Communicate with branch staff regarding eligibility, insurance, and authorization questions regarding patients. Communicate with branch office staff regarding partial/denied authorizations. Review and process Eligibility and Auth Coordinator/Office Coordinator/Scheduler workflow each day, accurately and timely. Provide training of all new and current Authorization Specialists Develop and update training materials, SOPs. Schedule and facilitate cross-training of employees. Monitor trainee progress and effectiveness. Identify focus areas for competency assessments. Develop quality monitors to ensure all insurance requirements are met and track key performance measures. Analyze authorization denials and supervise appeals process and tracking. Maintain a current knowledge base related to insurance requirements for prior authorization. Serve as primary resource on prior authorization requirement for all Traditions contracted and non-contracted payers. Provide directions to staff communicating with patients regarding the prior authorization process including: explaining requirements, terminology, billing process, consent requirements and denials/appeals. Audit all new Authorization Specialists and existing specialists on a regular cadence. Follows all procedures as outlined in Standard Operating Procedures (SOP). Works within the policies as defined by Traditions Health. Ensuring phones are answered and calls are directed professionally and efficiently to appropriate staff while maintaining a pleasant and helpful demeanor. Eligibility and Authorizations- Coordinate and communicate all aspects and processes of new admissions/Reauthorizations/Additional authorizations in a timely manner. Verifies Insurance benefits and documents in coordination notes section of HCHB. Additionally, verify initial insurance coverage; enters patient information regarding authorizations/coverage approval. Follow-up coordination for all referrals and maintain detailed comprehensive documentation in EMR. Follow-up customer service calls for branch and patients Monitor workflow and Insufficient Authorizations reporting to ensure patient has adequate authorization for care. Provide effective communication to team members, Operational partners and maintains confidentiality. Demonstrate commitment, professional growth, and competency. Understands and exhibits Traditions Health Care Mission Statement and Care Core Values. Perform other duties as assigned. Traditions Health is highly invested in not only your overall health, but also your future. This is reflected in the benefits we provide and the opportunities we make available to our employees.

Benefits for eligible employees include:

Full range of health insurance-medical (BCBS with 3 medical plan options), dental & vision. Health Savings Account with employer contribution Company sponsored life insurance Supplemental life insurance Short and long-term disability insurance Accident & Critical Illness Employee Assistant Program Generous PTO (that increases with your tenure) 401(k) Retirement Plan with Employer Match Mileage reimbursement Continuing education opportunities Traditions’ Health aspires to maintain a market competitive, internally equitable, and performance-based rewards program in order to attract, retain, and motivate employees. This philosophy includes to pay commensurate with experience, skills, competencies, and individual performance.

Equal Employment Opportunity:

Traditions Health is an equal opportunity employer that is committed to diversity and inclusion in the workplace. We prohibit discrimination of any kind based on race, color, sexual orientation, national origin, disability, genetic information, pregnancy or any other legally protected characteristic.