Home Health Authorization Specialist

YELM US Associates, LLC; New York (NY); On-site; USD 34,000 - 39,000; Full time

Benefits offered by this job

Paid Time-Off

Medical Coverage

Vision

Dental Benefits

401k Retirement plan + Employer Match

Voluntary Life

Critical Illness

Group Hospital Indemnity

Accident Insurance

Job summary

YELM US Associates, LLC is the administrative division supporting our licensed home care agencies, Ultimate Care and Swift Home Care. This on-site authorization role offers $25-$28 per hour, with schedule Monday–Friday 9:00AM–5:00PM at 1000 Gates Avenue, Brooklyn, NY 11221, reporting to the Director of Authorizations.

You will process and track authorizations, review patient records, and communicate with insurers to secure and revise authorizations.

Qualifications

• Minimum of 1 year experience in an Authorizations related role in a Home Care agency.
• Proficiency with HHA eXchange.
• Proficiency with Excel.

Responsibilities

• Process and track authorizations for home health services, ensuring timely submission to insurance providers.
• Review patient records and treatment plans to ensure all required documentation is complete and accurate.
• Communicate with insurance companies to secure necessary authorizations for services.
• Communicate with insurance companies regarding revised authorizations and other requested documents.
• Manage and resolve issues related to denied or delayed authorizations, including re-submissions or appeals.
• Maintain detailed and accurate records of all authorization activities.
• Collaborate with clinicians, case managers, and other team members to ensure care plans align with authorization requirements.
• Stay updated on changes in insurance policies, billing codes, and regulatory requirements related to home care.
• Provide exceptional customer service to both internal and external stakeholders, ensuring clear and efficient communication.
• Weekly review of admissions, discharges, and temp auth reports
• Monitor payer Portals and follow up branch / Intake’s requests
• Notify the teams of changes in authorization e.g. Termination, Holds, Hospitalizations, Increases and Decreases.
• Verify Eligibility the first business day of the month and the 15th for flagged known potential issues, Reach out to all insurances Via email/phone regarding potential termination or continuations of services.
• Monitor the HHAEX Board (Accept or Deny cases)
• Monitor/review Payor messages on the Home screen, update HHAEX and advise Placement of any changes accordingly.
• Run Reports from HHAEX (Temp Report, Authorizations due by Date Report, Authorizations Report)
• Create Profiles for New members in HHAEX.
• Merge profiles so all Clinical Documents are kept in one place.
• Monitor Mail (some contracts still send authorizations via mail)

Skills

Organizational skills

Problem-solving

Communication

Collaboration

Education

High school diploma or equivalent

Tools

HHA eXchange

Excel

Job description

YELM US Associates, LLC is the administrative division supporting our licensed home care agencies, Ultimate Care and Swift Home Care. This on-site authorization role offers $25-$28 per hour, with schedule Monday–Friday 9:00AM–5:00PM at 1000 Gates Avenue, Brooklyn, NY 11221, reporting to the Director of Authorizations.

You will process and track authorizations, review patient records, and communicate with insurers to secure and revise authorizations.