Envision Healthcare

  • Authorization Specialist

    Job Locations US-OH-Dayton
    Company Evolution Health
    Requisition ID
    # of Openings
    All Positions
    Dayton, Ohio
  • Overview

    Gem City Home Care is currently hiring a full-time Authorization Specialist in our Dayton, Ohio office location.

    Position Offers:

    • Excellent Pay
    • Full Benefit Package
    • 401K with Company Match
    • Paid Holidays
    • Paid Time Off Accrual Upon Hire


    Primary function is to obtain authorization for home health services for all services ordered for all payers (Medicare replacement, Medicaid and commercial plans) that require an authorization.


    Essential Duties and Responsibilities:

    • Obtains authorizations and insurance verifications in a timely manner
    • Reviews the insurance verification and completes the authorization process within established time frames. Accurately enters data into software program
    • Receives MD order and coverage authorization from agency designee. Works closely with agency to meet established timelines
    • Works closely with and supports team efforts to accomplish authorization/verification
    • Requests authorization from insurance company case manager to provide specific services and parameters of care
    • Provides effective communication to patient/family, team members, and other health care professionals and maintains confidentiality
    • Negotiate rates with insurance provider if out-of-network
    • Adhere to all company policies and procedures.
    • Adherence to and compliance with information systems security is everyone’s responsibility. It is the responsibility of every computer user to: Know and follow Information Systems security policies and procedures. Attend Information Systems security training, when offered. Report information systems security problems.

    Non-Essential Duties and Responsibilities:

    • Perform other duties as assigned.


    Minimum Qualifications:



    • High School Graduate or equivalency  



    • Two (2) years relevant experience in medical field minimum. Intake experience helpful.
    • Experience in the health care billing industry, preferred.
    • Utilization management experience and pre-certification helpful.
    • Customer Service experience.

     Knowledge and Skills:

    • Knowledge of ICD 9 coding experience preferred
    • Ability to establish and maintain effective working relationships with all segments of the branch staff, billing and collections department and, insurance representatives
    • Self Starter and able to work independently
    • Ability to multi-task
    • Usage of Medical Terminology
    • Strong negotiation and conflict management skills
    • Computer literate and can learn new software programs
    • Can use basic office equipment

    EOE including Veterans and Disabled



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