Authorization Specialist I, RCM

Team Select Home Care of Colorado, LLC; Denver (CO); Hybrid; USD 25,000 - 29,000; Full time

Benefits offered by this job

Family Medical, Dental, and Vision

Paid Time Off and Paid Sick Time

401(k) Referral Program

Job summary

The Authorization Specialist at Team Select Home Care of Colorado, LLC processes insurance authorization requests and maintains records across all locations. Reporting to the Authorization Manager, you will verify eligibility, collect deductible and out-of-pocket details, and coordinate with staff to secure patient consents as needed.

You will enter authorization data into the EMR, ensure correct payor setup, generate routine reports, and maintain clear communication with internal and external

Qualifications

• Excellent verbal and written communication; ability to interact with field leadership.
• Strong organization and problem-solving skills.
• Ability to adapt to change and meet deadlines.
• Capable of professional communication with staff and patients, verbally and in writing.
• Maintain confidentiality of sensitive information.

Responsibilities

• Process authorization requests for all insurances; track and obtain authorizations across locations.
• Check eligibility/benefits at intake and monthly for non-Medicaid insurances.
• Gather details on deductible and out-of-pocket costs at start of each year.
• Notify staff when patients have responsibility and ensure informed consent with field staff.
• Data entry of authorization information into EMR; verify payor setup for active policies.
• Maintain electronic records of all authorizations and run department reports (daily/weekly/monthly).
• Communicate with internal and external customers to ensure accurate authorization use.

Skills

Excellent verbal & written comms

Organizational skills

Problem solving

Adaptability

Professional communication

Confidentiality

Data interpretation

Stress management

Education

High School Diploma or Equivalent

Job description

The Authorization Specialist is a position that performs the authorization requests for all insurances. This employee reports directly to the Authorization Manager, RCM.

Duties/Responsibilities

• Checking eligibility/benefits on patients as needed: Upon intake if not previously done for all patients and monthly on patients with non-Medicaid insurances and the beginning of each month where prior authorization is not required
• At the beginning of every new year, obtaining details on eligibility, patients deductible and out of pocket costs
• Communicating any patients that will have a patient responsibility with the appropriate staff so they can verify the patient will want services and to inform field staff to correctly fill out the consents
• Tracking and obtaining all authorizations for all locations, along with reauthorization throughout duration of patient care
• Data entering all authorization information into the system
• Verifying accuracy in payor setup in EMR for all active policies
• Maintain electronic record of all authorizations
• Run reports daily, weekly, and monthly for department
• Communicate with both internal and external customers to ensure authorizations are utilized accurately
• Performs other duties as assigned

Required Skills/Abilities/Knowledge

• Excellent verbal and written communication skills with ability to communicate across all levels of field-based leadership
• Demonstrates high degree of organization and problem solving
• Able to effectively deal with change
• Able to complete projects and tasks within specific timetables
• Able to successfully interact with people in face-to-face situations as well as by telephone in a professional and effective manner
• Requires the ability to communicate verbally and in writing and to maintain confidentiality of sensitive information
• Requires the ability to use logical and scientific thinking to interpret technical data and solve a broad range of problems including the ability to use complex techniques to assess situations
• Requires the ability to interpret, adapt and react calmly under stressful conditions
• Must be able to relate cooperatively and constructively with clients and co-workers

Education/Experience/Licenses/Certifications

High School Diploma or Equivalent

Physical Requirements

“You are not required to disclose information about physical or mental limitations that you believe will not interfere with your ability to do the job. However, you should disclose any physical or mental impairment for which special arrangements or accommodations are needed to enable you to perform the essential functions of the job. Your description of any impairment and suggestions for reasonable accommodations will be considered in providing reasonable accommodations.” Requires the ability to write, dictate or use a keyboard to communicate directives Utilizes proper body mechanics in multiple environments Requires the ability to function in multiple environments

FLSA Status

Non-exempt

EEO Status

Administrative Support Worker

Benefits + Perks of Joining the Team

• Family Medical, Dental, and Vision Insurance
• Paid Time Off and Paid Sick Time
• 401(k) Referral Program

Pay Range

$18.00 - $21.00 / hour

Team Select Home Care reserves the right to change the above job description and qualifications without notice. Team Select Home Care will not discriminate against you on the basis of race, color, religion, national origin, sex, sexual preference, disability, political belief, veteran status, age, or any other status protected by law. Team Select Home Care is an employment-at-will employer. Team Select Home Care is dedicated to transforming lives by providing compassionate, high-quality in-home care. Founded in 2008, our mission is to change lives for the better. We advocate for families in need, treat our patients like the heroes they are, and empower our team members to make a meaningful difference every day. We specialize in long-term adult and pediatric private duty nursing, personal care services, and family caregiving programs, all with a personalized, patient-centered approach. Our commitment to excellence is reflected in everything we do, from the way we care for our patients, to how we support our team. We believe that our employees are the heart of our mission, and we’re dedicated to your growth and well-being. At Team Select, you’ll find opportunities for continuous training, career advancement, and professional development.