- Microsoft Excel
- Computer skills
- Data entry
- Microsoft Office
- Microsoft Word
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.
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..
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.
The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. 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. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions upon request.
Help At Home is an Equal Employment Opportunity (EEO) employer and welcomes all qualified applicants. Applicants will receive fair and impartial consideration without regard to race, sex, color, religion, national origin, age, disability, veteran status, genetic data, or religion or other legally protected status.