Innovive Health provides a supportive environment where clinicians can make a meaningful impact in the lives of patients by delivering care in the comfort of their home.
Our dedicated teams go above and beyond to provide high-quality, compassionate care, and we believe the quality of our employees is the foundation of the care we deliver. Our employees are our biggest asset.
- We offer a competitive salary and a generous benefits package.
- Flexible Schedules to fit your lifestyle.
- Medical, Dental, and Vision Benefit
- Mileage Reimbursement
- 401k with company match
- Dayforce Wallet - a voluntary benefit that gives you access to earned pay,
- Employee Assistance Program
- Online CEU credits
- Rewarding one-on-one care,
- one-on-one mentoring and 24/7 clinical support
- Excellent career growth opportunities
POSITION SUMMARY:
The Authorization Representative is a part of a fast-pace and dynamic department that plays a crucial step in making sure that the patients are eligible to receive our services. The individual filling this position is an ambitious, hands-on problem solver, and effective communicator that will support the achievements of the team. The role includes the following: insurance verifications, obtaining authorizations, and patient eligibility.
RESPONSIBILITIES:
- Obtain prior authorization or pre-certification of services to be rendered as required by each individual payor.
- Answer incoming telephone calls and triage to appropriate personnel as indicated.
- Complete and manage all paperwork or supportive documentation required for performing effective billing.
- Re-verify patient eligibility, monitor insurance lifetime caps and prior authorization periods.
- Resolve patient/payor issues in a timely manner.
- Run various reports to keep up with patient caseload and Utilization Review Maintenance
- Participate in departmental, clinical and company meetings as requested.
- Participate in required training including, but not limited to, in-service and educational programs.
- Performs other duties as assigned.
COMPETENCIES:
- Oral Communication - Speaks clearly and persuasively in positive or negative situations; Listens and gets clarification; Responds well to questions; Demonstrates group presentation skills; Participates in meetings.
- Written Communication - Writes clearly and informatively; Edits work for spelling and grammar; Varies writing style to meet needs; Presents numerical data effectively; Able to read and interpret written information.
- Problem Solving - Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Develops alternative solutions; Works well in group problem solving situations; Uses reason even when dealing with emotional topics.
- Customer Service - Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to requests for service and assistance; Meets commitments.
- Teamwork - Balances team and individual responsibilities; Exhibits objectivity and openness to others' views; Gives and welcomes feedback; Contributes to building a positive team spirit; Puts success of team above own interests; Able to build morale and group commitments to goals and objectives; Supports everyone's efforts to succeed.
REQUIRED QUALIFICATIONS:
- Associate degree or equivalent in related work experience
- Minimum of 1 years’ experience in an office setting
- Proficiency in Microsoft Office
Preferred Education and Experience:
- Healthcare experience preferred
PHYSICAL DEMANDS AND WORK ENVIRONMENT:
- Occasionally required to stand.
- Occasionally required to walk.
- Frequently required to sit.
- Continually required to use hands and fingers.
- Occasionally required climb, balance, bend, stoop, kneel or crawl.
- Occasionally required to lift/push light weights (less than 25 pounds).
TRAVEL REQUIREMENTS:
- Ability to travel locally by car to office(s), events, meetings, etc., as needed (approximately 5% or less of the time).
- meetings, etc., as needed (approximately 5% or less of the time).
Innovive Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
