SCO and One Care Authorization Specialist
Job Description
Job Description
Job Title: SCO and One Care Authorization Specialist
Business Unit: Administration
Department: CSU
Reports to: Senior Provider Relations and Consumer Services Manager
FLSA: Non-Exempt
Classification: Full Time (35 hours)
Grade: 9
Salary Range: $50,000 - $60,000
SUMMARY OVERVIEW
The SCO/One Care Authorization Specialist has the primary responsibility of assisting the SCO/One Care Senior Director and Managers, in obtaining and verifying proper service authorizations. He or she is an organized, efficient and highly motivated individual with a passion for extreme accuracy. He or she is also resourceful and possesses a high degree of integrity. The SCO/One Care Authorization Specialist will focus on getting the job done right, the first time. Our ideal candidate comes with home care service experience, clinical experience, dealing with the various "services" which the ASAP network provides to our consumers. Experience in the health-care industry and strong communication skills dealing with obtaining authorizations and collaborative other interactions with insurance companies are essential to this role.
ESSENTIAL FUNCTIONS
Duties 1-8 are designated as ADA essential functions and must be performed in this job. All other job duties are secondary functions.
- Prepares thorough reports on billing activity with clear and reliable data.
- Verifies discrepancies and resolves SCO/One care billing issues and short payments.
- Maintains and updates customer records in appropriate software.
- Collect appropriate authorizations to support service delivery.
- Researching authorization and coverage denials.
- Vigilant follow up of all denials with regular assigned projects.
- Assist in resolving provider billing discrepancies every month.
- Collaborate with multiple insurance carriers.
COMPETENCIES
- Deep knowledge and understanding of billing software and collections procedures.
- Strong computer skills, especially Microsoft Excel (Pivot tables, V-Lookups, etc.)
- Team player with a willingness to get to know their colleagues
- Character of integrity and dependability
- Above average organization skills with a keen ability to prioritize
- Excellent communication skills
- Proactive and resourceful
- Possesses a positive attitude
- Ability to manage multiple tasks concurrently, and being able to switch gears seamlessly
- Attention to accuracy and detail
SUPERVISORY RESPONSIBILITY
This position has no supervisory responsibilities.
WORK ENVIRONMENT
This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, printers, copiers, filing cabinets.
PHYSICAL DEMANDS
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
- The employee must be able to carry 10 to 15 lbs.
- The employee is regularly required to talk and hear
- The employee is frequently required to stand, walk, use hands to finger, handle or feel, and reach with hands and arms
POSITION TYPE/EXPECTED HOURS OF WORK
This is a full-time position, Monday-Friday, 9 a.m. - 5 p.m. Hybrid work schedule; Minimum of two days per week onsite is required.
REQUIRED/PREFERRED EDUCATION AND EXPERIENCE
- Billing experience required
- Excel/spreadsheet experience required
- Microsoft office suite familiarity
- Understanding of homecare/healthcare environment
ADDITIONAL ELIGIBILITY QUALIFICATIONS
None required for this position.
WORK AUTHORIZATION/SECURITY CLEARANCE
- Must be able to work in the United States
AAP/EEO STATEMENT
Equal Employment Opportunity/Affirmative Action/Male/Female/Veteran/Disabled - Boston Senior Home Care affirms and supports diversity and inclusion in our workforce and recognizes all EEOC Factors.
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.
Given the nature of the organization and the population it serves, all new employees are required to clear a CORI prior to taking on a new role.
Job Posted by ApplicantPro