Managed Care Authorization Specialist - AgeSpan

AgeSpan

Formerly Elder Services of the Merrimack Valley/North Shore

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

Depending on your role and your hours, we offer:

• Flexible schedule and hybrid work opportunities
• Competitive salaries
• Healthcare (medical, dental)
• 403b Retirement Plan with agency match
• 20 Vacation Days, 12 Sick Days, and 12 Paid Holidays
• Social Work Licensing Program
• License Renewal Paid by agency for RN's and Social Workers
• And MORE!

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:

1. 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.
2. 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.
3. Data entry as requested or as needed in A&D or SCO databases including adding new members and closing disenrolled members
4. Monthly review and reconciliation of membership roster as needed.
5. Work collaboratively with the billing department to resolve issues and decrease claim denials due to authorization issues.
6. Support Management with updates and maintenance of forms and document, both digital and paper.
7. Upload documents and document consumer related activities in A&D database.
8. Prepare packets, mailings and assist with other special projects on both a regularly occurring and as needed basis.
9. Attend any team, Managed Care Department and All Staff meetings and complete agency required trainings.
10. Other related duties, as required.

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. Critical thinking, (add language about time management/details here) (Don't need language abilities) Proficient in Office 365 with the ability to master new procedures with minimal oversight; strong interpersonal and organizational skills, 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: 37.5 per 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.