Authorization Specialist - Remote

Position Overview

The Authorization Specialist facilitates the coordination between healthcare providers, clinical teams, and insurance carriers to ensure that necessary approvals are obtained, and payment processes are streamlined.

Essential Job Functions
- Oversee the insurance authorization process for requested patient services to ensure timely approvals are obtained.
- Initiate communication with the patient's insurance provider upon receiving referral information from the clinical team, specifically for services requiring pre-certification or authorization.
- Proactively engage with insurance carriers to facilitate the timely receipt of all required payment information.
- Keep assigned location teams informed of any changes in requirements by insurance companies related to authorizations and eligibility.
- Coordinate activities with location teams in response to payer coverage decisions, including denials, change in hours, or pending information.
- Ensure completeness of submissions by verifying all necessary information is included.
- Maintain consistent communication with the location team throughout the authorization process, providing regular updates on the status of service requests with insurance carriers.
- Track authorization expirations and report any issues that may lead to an authorization lapse to location management for resolution.
- Adhere to the Aveanna Compliance Program, including following all regulatory Aveanna and accrediting agency policies.

Requirements
- High school diploma
- 2+ years of related experience
- Strong computer skills (Word, Excel, Power Point)

Preferences
- PA state-specific payer experience

- Bachelor's Degree
- Bilingual; Spanish speaking a plus

Other Skills / Abilities
- Proficient in Microsoft suite of products including Outlook, Word and Excel
- Must be able to adhere to confidentiality standards and professional boundaries at all times
- Excellent communication skills both written and verbal
- Must possess a strong sense of urgency and attention to detail
- Proven ability to work independently at times and within a team
- Demonstrated ability to prioritize multiple tasks to meet deadlines
- Demonstrated ability to interact in a collaborative manner with other departments and teams

Physical Requirements
- Must be able to speak, write, read and understand English
- Occasional lifting, carrying, pushing and pulling of 25 pounds
- Prolonged walking, standing, bending, kneeling, reaching, twisting
- Must be able to sit and climb stairs
- Must have visual and hearing acuity
- Must have strong sense of smell and touch

Environment
Performs duties in an office environment during agency operating hours
Must be able to function in a wide variety of environments which may involve exposure to allergens and other various conditions

Other Duties
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

Vaccine Requirement
As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all relevant jurisdictions, including required vaccinations and testing, subject to exemptions for medical or religious reasons as appropriate.