COMPANY WEBSITE: https://freedomhealthcare.biz/
COMPANY PHONE NUMBER: (667) 770-6320
HUMAN RESOURCES PHONE NUMBER: (410) 372 4513
POSITION TITLE: Authorization Verification Specialist
ALTERNATE TITLE(S): Authorization Verification Specialist
COMPANY: Freedom Health Systems, Inc.
DIVISION: Operations Division
DEPARTMENT: Scheduling Department
UNIT: N/A
CLASSIFICATION: W8BEN Independent Contractor. 40 hours per week. Exempt.
COMPENSATION RANGE: $5.00 per hour
WORK SCHEDULE: Monday to Thursday 8AM - 7PM
ACCOUNTABLE TO: Scheduling Department Manager
ACCOUNTABLE FOR: CODC, ECM, CRNP, CRNP-F, DSP, CPRS, HHCM
ANTICIPATED TRAVEL: 0% of the time
SUMMARY OF POSITION RESPONSIBILITIES: The Authorization Verification Specialist is responsible for ensuring that all active clients have obtained the necessary managed care authorizations for required services in accordance with their category type. This role involves collaborating with the Revenue Cycle Department, to maintain up-to-date authorizations, manage the discharge process, and monitor new intake clients. The specialist will play a crucial role in maintaining the accuracy and compliance of client records, facilitating communication between departments, and supporting the efficient operation of client services.
SCHEDULED DUTIES AND RESPONSIBILITIES:
- Maintain accurate records to ensure that all active clients have obtained the necessary managed care authorization for every required service in accordance with their category type.
- Verify that authorizations are secured five to seven days prior to the scheduled appointment date.
- Work closely with the Revenue Cycle Department to inform them of clients whose authorizations have expired and require re-obtention to maintain program services.
- Provide timely updates to relevant stakeholders about the authorization status of clients.
- Monitor the discharge process by confirming that providers have created both a discharge summary in ICANotes and a valid discharge ticket within the ticketing system for discharged clients.
- Ensure the removal of discharged clients from Clinical Schedules once all necessary discharge documentation is secured.
- Perform daily authorization verification for the following week, including addressing any backlogs.
- Conduct weekly monitoring of Medicaid authorizations to ensure compliance and accuracy.
- Distribute daily emails/notification to the Revenue Cycle Management (RCM) team for clients needing authorization re-obtention.
- Generate and distribute weekly and monthly reports on the number of clients without authorization, ensuring timely and accurate information is provided to relevant departments.
- Track and manage the discharge status of clients, ensuring that clients who wish to continue with the program without being housed are appropriately transitioned.
- Conduct outbound calls to Discharged Category A clients to confirm their continued interest in the program as community clients.
- Delete future appointments for discharged clients once the discharge ticket and summary have been created.
- Monitor and track uninsured clients to ensure appropriate follow-up and action.
- Oversee the New Intake Client Log tracker, ensuring that all new intake clients have accurate time stamps and that the log is regularly updated.
UNSCHEDULED DUTIES AND RESPONSIBILITIES:
- Participate in external and internal audits/surveys (CARF/CSA/OHCQ) as directed by the supervisor.
- Participates in quality assurance and performance improvement plans by completing periodic audits or other activities to ensure regulatory compliance and/or improve service delivery.
- Assist the supervisor, HR, or management with any work-related tasks as requested.
- Responsible for following regulations of COMAR, CARF, any other regulatory body, and company policies/procedures related to your scope of work.
- Co-facilitating orientation of all new hires if requested.
- Support the maintenance of a safe environment by participating in training and drills as requested.
- Advise the supervisor on the development and implementation of protocols to better enhance the efficiency of day-to-day operations effecting change when approvals are made.
- Troubleshoot and abate any issues that could adversely affect the day-to-day operations.
- Report to the Supervisor daily and as requested. Report deviation of operational standards to CEO daily.
- Check emails and company group texts at least every 30 minutes while on duty; respond accordingly.
PHYSICAL DEMANDS: Regularly required to stand, sit, talk, hear, reach, stoop, kneel, and use hands and fingers to operate a computer, telephone, and keyboard.
WORKING CONDITIONS: Remote work environment
DISCLOSURES: The specific statements shown in each section of this job description are not intended to be all inclusive. They represent typical elements and criteria considered necessary to perform the job successfully. The job’s responsibilities/tasks may be modified and/or expanded over time. Company will inform the personnel member when changes in the respective job description are made.
