Case Manager

Help At Home West Alton , IL 62923

Posted 2 days ago

Help at Home is hiring a Entry Level Authorization Representative! Perfect opportunity for a New Graduate!

Help at Home is the nation's leading provider of high quality care and support solutions. Our goal is to enable the highest level of personal independence and meaningful lives for our clients. Help at Home is committed to delivering a gold standard in care through our attentive and well-trained staff who support our clients comfortably and safely within their homes and communities.

The RCM Representative - Authorization reports to the Authorization Supervisor. This position performs general data entry & keying tasks for the Revenue Cycle Management Department's authorization management functions that require a high degree of attention to detail, and the ability to analyze and resolve routine problems.

Responsibilities

  • Obtain authorizations from HHAeXchange and enter information into Sandata SAM system.

  • Identify an over/under authorizations. Contact Service Coordinators and/or Managed Care Organizations to confirm or correct as needed.

  • Work with Case Managers to adjust the schedule to properly utilize the authorization.

  • Utilize payor portals, HHAeXchange, MCO provider lines and email to communicate and resolve authorization issues.

  • Identify Managed Care Organization and authorization changes as they are occurring, correct and modify master profiles as necessary.

  • Keep track of all authorizations and expiration dates of the authorizations. Obtain new authorizations before expiration dates.

  • Alerts the Administrator or Manager regarding late or missing documents required for billing.

  • Produces reports as needed.

  • Performs administrative duties such as sorting, scanning, filing, and emailing records.

  • Performs other related duties as assigned..

Qualifications

  • 1-2 years' experience of data entry, record keeping or similar experience in the healthcare field.

  • Knowledge of Medicaid/ Managed Care Organization (MCO), insurance verification and authorization management.

  • Intermediate to advanced computer skills, including the use of Microsoft Office applications (e.g. Word, Excel) and knowledge of Sandata, MCO portals, HHAeXchange and Waystar (Zirmed) is preferred.

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Case Manager

Help At Home