AUTHORIZATION AND REIMBURSEMENT ASSISTANT

Job Description: Authorization and Reimbursement Assistant

Position Summary: Provides data entry functions and assists with the agency authorization and invoicing processes.  Ensures accurate and timely entry of all authorizations for services and submission of invoices for billing.  Prepares claims for submission as directed by the reimbursement specialist.  Performs Information Technical Support services and assist the Reimbursement Specialist.

Reports to: Reimbursement Specialist

Qualifications

  1. High school graduate, minimum; two year degree in business related field, preferred.
  2. Minimum of one (1) year general office experience with some data entry.
  3. Computer literate for functions of data entry and basic word processing.
  4. Knowledge of medical terminology and/or general medical background desirable.
  5. Accurate and detail-oriented tendencies.

Essential Functions/Areas of Accountability

Enter all authorizations for Divine Home Care.

  1. All authorizations need to be entered by Wednesday morning each week.
  2. It is the responsibility of the enterer to assure that all contracted reimbursement rates are entered correctly.
  3. Report to Reimbursement Specialist any concerns or issues with authorizations or any reasons not to bill.
  4. After authorizations are entered, scan into client’s chart.
  5. Personal calls and personal texting need to be accepted minimally while in the office. Request the caller to contact you at noon, breaks, or after office hours.

  1. Assist Reimbursement Specialist as needed to complete and thoroughly review all billing reports by 11 a.m. Wednesday mornings.
  1. Assist with billing as directed
  2. Assist with fixing billing errors as requested

 

  1. Primary authorization person
  2. Assist Nurse Case Managers with authorization requests.
  3. Provide instruction as required via email, phone or in person.

 

  1. Maintains confidentiality of all client and employee information.
  1. Performs job in compliance with agency policies and procedures as well as community standards and applicable laws.
  1. Communicates necessary information to Supervisor and management staff to assure accuracy of data and coordination of agency functions.
  1. Performs additional duties and responsibilities as deemed necessary.
  1. Performs additional duties and responsibilities as deemed necessary as the contact person for all authorizations concerns with all the branch offices and administrative staff.

Physical/Environmental Demands: See ADA Requirements.