Managed Care Authorization Specialist

AgeSpan

Formerly Elder Services of the Merrimack Valley/North Shore

About Us: Since 1974 our agency has strived towards supporting an individual's desire to make their own decisions, secure their independence and remain living independently in the community. We are proud of our employees who make this possible every day. Our agency is a thought-leader, a nationally known generator of new ideas, because it welcomes creativity, your ideas. It is an outstanding place to work stimulating, friendly, collaborative. We offer competitive salaries, generous vacation time, and an excellent work/life balance. We value diversity and encourage career growth. If you have a passion for improving the lives of the elderly community and enjoy working in a diverse team driven by its mission, you've found the right place!

At AgeSpan, You'll Find a Work Environment That Combines

• A refreshing culture that is supportive, collaborative, and encouraging of diverse perspectives and backgrounds.
• A satisfying balance between your work and personal life, including a flexible workplace, generous paid time off, and wellness programs.
• Encouragement of your development through opportunities to get involved, use your voice, and gain new knowledge and skills.
• A focus on innovation with a team recognized for developing and implementing innovative programs and novel solutions.

Depending on your role and your hours, we offer

• Employee Assistance Program
• Tuition Remission Program
• Free parking
• Competitive salaries
• Social Work Licensing Program
• Commitment to promoting within
• Flexible schedule and hybrid work opportunities
• License Renewal Paid by agency for RN's and Social Workers
• 20 Vacation Days, 12 Sick Days, and 12 Paid Holidays
• Employee Referral Bonuses
• Healthcare (medical, dental)
• Mileage reimbursement
• Agency subsidized gym membership (on-site in Lawrence)
• 403b Retirement Plan with agency match

Position Responsibilities

Provide critical administrative support to the Managed Care Department with a focus on authorizations, billing denials, and communications with internal and external partners.

Core Duties

• Upload documents and document consumer related activities in A&D database.
• Work collaboratively with the billing department to resolve issues and decrease claim denials due to authorization issues.
• Monthly review and reconciliation of membership roster as needed.
• Other related duties, as required.
• Prepare packets, mailings and assist with other special projects on both a regularly occurring and as needed basis.
• Primary contact for provider communications for selected home care services such as Adult Day Health, Durable Medical Equipment requests, etc. Process communications to staff and may complete data entry in A&D.
• Data entry as requested or as needed in A&D or SCO databases including adding new members and closing disenrolled members
• Oversight and coordination of United SCO service authorization process which includes receiving and processing authorizations, tracking of authorizations, data entry into A&D/United SCO database, reporting, collaborating with fiscal department, and assisting with any follow as needed.
• Support Management with updates and maintenance of forms and document, both digital and paper.
• Attend any team, Managed Care Department and All Staff meetings and complete agency required trainings.

Qualifications: Associates Degree with 2 years of administrative support experience required, preferably in the areas of medical billing or healthcare prior authorization processing. High school diploma with at least five years of administrative experience may be considered. Proficient in Office 365 with the ability to master new procedures with minimal oversight; strong interpersonal and organizational skills, critical thinking, attention to detail, able to prioritize, multitask and work well in a fast-paced team environment. Must work well independently as well as collaboratively. Prior experience with large client databases a plus.

Hours: 37.5hrs/week

AA/EOE

AgeSpan is strongly committed to fostering a professional environment that recognizes, respects, and encourages the unique contributions of a broad spectrum of qualified employees. It is important that our employees reflect the diverse communities we serve. We maintain a work atmosphere that allows people of varied backgrounds to grow professionally and contribute to our mission by promoting diversity, equity, inclusion, and work-life balance.

Job Posted by ApplicantPro