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Symbii Home Health and Hospice South
Authorization Specialist
Career Insights for Eligibility Specialist
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Based on Utah data
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What they do
An Eligibility Specialist provides assistance and information for people who apply for a government benefits program or health care program. Answers questions, assists with an application process, and reviews applications and relevant background information to determine eligibility. May assist eligible applicants with enrolling in a program.
$52,379 / year median in Utah
+22% projected growth
Job Description
Job Description Summary The Authorization Specialist obtains insurance verification on patient admissions and recertification's and works with Billing and Patient Care Staff to resolve issues. Essential Job Functions/Responsibilities Contact insurance company/case managers to verify patient insurance coverage and obtain information concerning the extent of benefits. Utilize the UGS/DDE and EDS computer programs to verify eligibility for Medicare and Medicaid, and thoroughly research any possible secondary payers. Prepare insurance verification form with data such as names of insurance company and policyholder and policy number. Accurately enters insurance information into Homecare Homebase (HCHB). Prepare estimates of patient copayment for clinician to deliver to patient, and notifies clinician of preauthorized visits. Enters visit authorizations into HCHB computer system and maintains an audit system for additional visit authorization needs. Reports unauthorized visits to supervisor when applicable. Maintains audit system for tracking True Blue authorizations for recertification. Maintains audit system for tracking hospice recertification's. Submit CHAPS reporting for both Home Health and Hospice (critical) Provides HCHB support, guidance and consistent training in conjunction with the Director of Nursing and Director of Operations. The above statements are only meant to be a representative summary of the major duties and responsibilities performed by incumbents of this job. The incumbents may be requested to perform job-related tasks other than those stated in this description.