Authorization And Eligibility Manager

BrightSpring Health Services

Responsible for overseeing the agency's Authorization Department by supervising the Authorization Specialists. Oversees and assists in the process of obtaining and tracking authorization for all patients for whom their insurance requires pre-authorization, and ensures the agency has the authorization required to bill for services provided.

Answers telephones and provides excellent customer service to our professional staff and insurance representatives.
• Runs and utilizes computer reports regularly.
• Provides accurate, complete updates to Agency management on status of authorizations for all patients requiring treatment authorization.
• Ensures insurance eligibility is completed and accurate for all patients.
• Ensures authorization is obtained and tracked for all patients whose insurance requires pre-authorization
• Ensures all authorization requests and insurance eligibility are documented clearly.
• Participates in planning for the orientation and education of employees as it relates to Authorization department.
• Oversees, approves, and manages departmental payroll, PTO, and overtime requests.
• Ensures objectives are implemented; follows and promotes agency policies and procedures.
• Serves as a role model for all colleagues by setting an example of high standards in dress, conduct, cooperation, and job performance.
• Observes confidentiality and safeguards all patient related information.
• Notifies Supervisor of problems in a timely manner and works to help provide solutions.
• Completes ongoing education requirements and demonstrates ongoing competency in required areas.

• High school graduate or GED.
• Minimum of two (2) years of experience in health care billing and/or authorization practices.
• Minimum of one (1) year of supervisory or management experience.
• Must have an active and unrestricted driver's license with appropriate auto insurance.
• General knowledge of the framework, organization, and function of home care.
• Sound knowledge of health care operations and third-party reimbursement.
• Proficient in the use of Microsoft Office (Word, Excel, Outlook, Internet Explorer) with the ability to learn industry specific software applications.
• Solid organizational skills, thoroughness, and a keen attention to detail with the ability to multi[1]task while prioritizing effectively.
• Ability to work independently and in a team environment.
• Excellent, oral, written, and interpersonal communication skills.
• Professional appearance and demeanor.