Important notice: SalusCare, Inc. is an equal opportunity employer. All applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, genetic information, marital or veteran status, disability or any other characteristic protected by law. SalusCare, Inc.is a drug free workplace and adheres to the drug free workplace program as outlined under Florida worker’s compensation law. All applicants being considered for employment will be required to undergo a drug screen. Refusal to submit or positive results of the test will prohibit you from being offered employment.
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Authorization Specialist
Job Code:21-033-001
Campus/Location:Ortiz Campus
FT/PT Status:FT- 40 hrs/wk - Hourly
Work Hours:8:00 AM - 5:00 PM
  

Job Responsibilities:
This position will telecommute and complete work remotely from a location that consistently ensures the confidentiality of protected patient information. 

1. Competently verifies insurance benefits and accurately enters information in to the electronic 
health record. 

2. Routinely processes internal referrals, according to the departmental/agency procedures, 
including obtaining authorizations from third party payors, and enter same into appropriate data bases. 

3. Effectively performs ongoing certification requests for all managed care contracts, third party contracts, and/or Medicaid HMO contracts as per the individual company’s constraints.

4. Successfully processes all clinical updates and retro reviews/appeals and forwards all required paperwork to the appropriate insurance company.

5. Consistently makes recommendations to service program administration for corrective actions needed to make timely referrals, authorizations, and recommendations for appropriate services (documentation, etc.).  

6. Accurately enters patient data in appropriate tracking databases within required timeframes.

7. Routinely provides back-up coverage to any other UM staff member as dictated by the team’s work load or absence.

8. Continuously maintains compliance with staff development training curriculum requirements.

9. Routinely demonstrates a sound understanding of and commitment to complying with CARF standards for the Billing and Utilization Management department.

10. Demonstrates an understanding and respect for cultural competence and sensitivity when interacting with other employees, consumers of SalusCare services, visitors, vendors, and other persons.  

11. Effectively attains competence with company electronic medical record and uses it effectively within required time frames.

12. Successfully performs other duties as assigned by supervisor. 

Job Qualifications:
Requires BA/BS degree.  Requires at least six (6) months of managed care, mental health, substance abuse, or medical health work experience.  Additional experience may be considered in lieu of a degree.  Must be competent in Microsoft Word.